Het volume van chirurgische ingrepen en de impact ervan op ... - KCE

KCE Reports 113 Volume Outcome 119
5.6.6 Volume outcome relationship
5.6.6.1 Analysis by hospital
Figure 5.29 presents the funnel plot of the number of lung cancer surgeries and the 2year
mortality (observed, i.e. without risk adjustment). The size of the point is
proportional to the number of hospitals with the same volume and the same outcome.
The horizontal line represents the overall 2-year mortality i.e. 26.5%. None of the
hospitals are outliers above the 99.8% limits of variability.
Figure 5.30: Lung cancer surgery: Funnel plot of 2-year mortality rate, by
hospital
DESCRIPTION OF DIFFERENCES IN CHARACTERISTICS ACCORDING TO
THE VOLUME CATEGORY OF THE HOSPITAL
Table 5.68 presents differences in case mix and outcome based on hospital volume. The
smallest volume category is based on the 25 th percentile (4 interventions/year). The four
other volume categories are chosen arbitrary by increases in volume of 5, 10 and 20
interventions. Age and sex are not associated with volume. More patients with Charlson
score ≥ 3 and with APR-DRG severity 3 or 4 are present in very small volume centres
(40/year), where it drops to
21.4%.