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

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218 Volume Outcome KCE reports 113 Regardless of the desirability of centralisation, it is clear that no programme will ever succeed in getting all high-risk procedures into high-volume centres. Therefore, some authors argue that instead of centralisation, it is probably worthwhile to develop strategies for improving care in ALL hospitals, even low volume ones. This should be done by setting a goal of improving surgical quality of care by improving the processes of care. Anyway, the merits and drawbacks of centralisation of health care are beyond the scope of this report. Our analyses were not intended to determine thresholds but were primarily designed to assess the feasibility of a volume outcome study with Belgian administrative data and to validate the existence of volume-outcome associations. The fact that this study is based on relatively old data (2004) calls for some caution in the effects observed. Many changes have been introduced in our health care system since 2004. Fusion of hospitals, creation of Belgian cancer registry, introduction of the multidisciplinary consultations in oncology, introduction of minimal volumes in the treatment of breast cancer, etc… All those factors have a potential impact on the quality of care. All our results are thus valid for the year 2004, but might not be applicable now. Our final conclusion is that Belgian administrative data linked to registry data can be an adequate tool to study the volume outcome relationship, provided necessary precautions are taken.
KCE Reports 113 Volume Outcome 219 9 REFERENCES 1. Halm EA, Lee C, Chassin MR. Is volume related to outcome in health care? A systematic review and methodologic critique of the literature. Ann Intern Med. 2002;137(6):511-20. 2. Van Den Bruel A, Vlayen J, Gailly J, Chalon P, Ramaekers D. Good Clinical Practice (GCP). Process notes. Brussels: Belgian Health Care Knowledge Centre (KCE); 2007. KCE Process notes (D2007/10.273/38) 3. NHS Centre for Reviews and Dissemination. Relationship between volume and quality of health care: a review of the literature. York: University of York; 1995. CRD Report 2 Available from: http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?View=Full&ID=31999008337 4. Hannan EL. Evaluating and improving the quality of care for acute myocardial infarction: can regionalization help? Jama. 2006;295(18):2177-9. 5. Gandjour A, Bannenberg A, Lauterbach KW. Threshold volumes associated with higher survival in health care: a systematic review. Med Care. 2003;41(10):1129-41. 6. Guyatt G, Gutterman D, Baumann MH, Addrizzo-Harris D, Hylek EM, Phillips B, et al. Grading strength of recommendations and quality of evidence in clinical guidelines: report from an american college of chest physicians task force. Chest. 2006;129(1):174-81. 7. Biewener A, Aschenbrenner U, Sauerland S, Zwipp H, Rammelt S, Sturm J. Impact of rescue pathway and hospital volume on the mortality of polytraumatized patients. Status report. Unfallchirurg. 2005;108(5):370-7. 8. Urbach DR, Croxford R, MacCallum NL, Stukel TA. How are volume-outcome associations related to models of health care funding and delivery? A comparison of the United States and Canada. World J Surg. 2005;29(10):1230-3. 9. Banta D, Bos M. The relation between quantity and quality with coronary artery bypass graft (CABG) surgery. Health Policy. 1991;18(1):1-10. 10. Banta HD, Engel GL, Schersten T. Volume and outcome of organ transplantation. Int J Technol Assess Health Care. 1992;8(3):490-505. 11. Bentrem DJ, Brennan MF. Outcomes in oncologic surgery: does volume make a difference? World J Surg. 2005;29(10):1210-6. 12. Black N, Johnston A. Volume and outcome in hospital care: evidence, explanations and implications. Health Serv Manage Res. 1990;3(2):108-14. 13. Black PC, Brown GA, Dinney CP. Should cystectomy only be performed at high-volume hospitals by high-volume surgeons? Curr Opin Urol. 2006;16(5):344-9. 14. Casson AG, van Lanschot JJ. Improving outcomes after esophagectomy: the impact of operative volume. J Surg Oncol. 2005;92(3):262-6. 15. Chang AC, Birkmeyer JD. The volume-performance relationship in esophagectomy. Thorac Surg Clin. 2006;16(1):87-94. 16. Dibra A, Kastrati A, Schuhlen H, Schomig A. The relationship between hospital or operator volume and outcomes of coronary patients undergoing percutaneous coronary interventions. Z Kardiol. 2005;94(4):231-8. 17. Dimick JB, Birkmeyer JD, Upchurch GR, Jr. Measuring surgical quality: what's the role of provider volume? World J Surg. 2005;29(10):1217-21. 18. Keck T, Makowiec F, Adam U, Hopt UT. [Does hospital volume have influence on the results of pancreatic surgery?]. Zentralbl Chir. 2007;132(1):26-31. 19. Kelly JV. What do mortality studies reveal about hospital volume, teaching status, and ownership? Int J Technol Assess Health Care. 1990;6(2):239-52. 20. Nathens AB, Maier RV. The relationship between trauma center volume and outcome. Adv Surg. 2001;35:61-75. 21. Nguyen NT, Higa K, Wilson SE. Improving the quality of care in bariatric surgery: the volume and outcome relationship. Adv Surg. 2005;39:181-91. 22. Snider RL, Laskey WK. Quality management and volume-related outcomes in the cardiac catheterization laboratory. Cardiol Clin. 2006;24(2):287-97, vii. 23. Bennett CL, Deneffe D. Does experience improve hospital performance in treating patients with AIDS? Health Policy. 1993;24(1):35-43.
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