Explaining variation in ventral and inguinal hernia repair outcomes: A population-based analysis

Surgery
Christopher T AquinaTodd A Jusko

Abstract

No study has evaluated the relative importance of patient, surgeon, and hospital-level factors on surgeon and hospital variation in hernia reoperation rates. This population-based retrospective cohort study evaluated factors associated with variation in reoperation rates for recurrence after initial ventral hernia repair and inguinal hernia repair. The Statewide Planning and Research Cooperative System identified initial ventral hernia repairs and inguinal hernia repairs in New York state from 2003-2009. Mixed-effects Cox proportional hazards analyses were performed assessing factors associated with surgeon/hospital variation in 5-year reoperation rates for hernia recurrence. Among 78,267 ventral hernia repairs and 124,416 inguinal hernia repairs, the proportion of total variation in reoperation rates attributable to individual surgeons compared with hospitals was 87% for ventral hernia repairs and 92% for inguinal hernia repairs. In explaining variation in ventral hernia repair reoperation between surgeons, 19% was attributable to patient-level factors, 4% attributable to mesh placement, and 10% attributable to surgeon volume and type of board certification. In explaining variation in inguinal hernia repair reoperation between...Continue Reading

Citations

Jun 5, 2018·ANZ Journal of Surgery·Rodney Jacobs
Nov 2, 2018·JAMA Surgery·Line SchmidtJacob Rosenberg
Feb 2, 2019·The British Journal of Surgery·C F JustinianoF J Fleming
Jan 24, 2019·Hernia : the Journal of Hernias and Abdominal Wall Surgery·F KöckerlingM P Simons
Feb 13, 2018·Annals of Surgery·Christopher T AquinaFergal J Fleming
Oct 31, 2018·Surgical Endoscopy·K Keano PavloskyDean J Mikami
Sep 12, 2019·Hernia : the Journal of Hernias and Abdominal Wall Surgery·J A WegdamM P Simons
Aug 11, 2018·Hernia : the Journal of Hernias and Abdominal Wall Surgery·A ChatthaA Patel
May 15, 2019·Annals of Surgery·Christopher T AquinaFergal J Fleming
Mar 11, 2020·Hernia : the Journal of Hernias and Abdominal Wall Surgery·S J ZolinD M Krpata
Jan 7, 2021·Hernia : the Journal of Hernias and Abdominal Wall Surgery·C ChristophersenJ Rosenberg
Jan 29, 2021·Annals of Medicine and Surgery·Rashid IbrahimSabry Abounozha
Jun 11, 2021·Journal of the American College of Surgeons·Camilla ChristophersenJacob Rosenberg
Dec 17, 2020·American Journal of Surgery·Ryan HowardDana A Telem

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