Neonatal surgery in low- vs. high-volume institutions: a KID inpatient database outcomes and cost study after repair of congenital diaphragmatic hernia, esophageal atresia, and gastroschisis

Pediatric Surgery International
Stig SømmeMoritz M Ziegler

Abstract

The volume-outcome relationship and optimal surgical volumes for repair of congenital anomalies in neonates is unknown. A retrospective study of infants who underwent diaphragmatic hernia (CDH), gastroschisis (GS), and esophageal atresia/tracheoesophageal fistula (EA/TEF) repair at US hospitals using the Kids' Inpatient Database 2009-2012. Distribution of institutional volumes was calculated. Multi-level logistic/linear regressions were used to determine the association between volume and mortality, length of stay, and costs. Total surgical volumes were 1186 for CDH, 1280 for EA/TEF, and 3372 for GS. Median case volume per institution was three for CDH and EA/TEF, and four for GS. Hospitals with annual case volumes ≥ 75th percentile were considered high volume. Approximately, half of all surgeries were performed at low-volume hospitals. No clinically meaningful association between volume and outcomes was found for any procedure. Median cost was greater at high- vs. low-volume hospitals [CDH: $165,964 (p < 0.0001) vs. $104,107, EA/TEF: $85,791 vs. $67,487 (p < 0.006), GS: $83,156 vs. $72,710 (p < 0.0009)]. An association between volume and outcome was not identified in this study using robust outcome measures. The cost of care w...Continue Reading

References

Sep 6, 2000·Annals of Surgery·J A O'NeillT M Krummel
Apr 12, 2002·The New England Journal of Medicine·John D BirkmeyerDavid E Wennberg
Dec 3, 2003·The New England Journal of Medicine·John D BirkmeyerF Lee Lucas
Jan 3, 2007·Archives of Pediatrics & Adolescent Medicine·Jay G BerryDon A Goldmann
May 13, 2009·Journal of Pediatric Surgery·Jeremy R GrushkaUNKNOWN Canadian Pediatric Surgery Network
Mar 22, 2012·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·S SømmeM Ziegler
Aug 29, 2012·Pediatrics·UNKNOWN American Academy of Pediatrics Committee on Fetus And Newborn
May 24, 2014·Journal of Pediatric Surgery·Keith T Oldham
Jun 21, 2014·Surgery·Jason P SulkowskiPeter C Minneci
Jan 17, 2015·American Journal of Perinatology·Jason M KaneTricia Johnson
Apr 17, 2016·Applied Health Economics and Health Policy·Woohyeon KimVivian Ho
May 4, 2016·Journal of Pediatric Surgery·Greg D SacksStephen B Shew
Feb 22, 2017·The Annals of Thoracic Surgery·Jeffrey P JacobsMarshall L Jacobs
Oct 23, 2018·Journal of Pediatric Surgery·Charles R HongBiren P Modi

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Citations

Dec 29, 2020·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·Elizabeth O'Connor, Bruce Jaffray
Mar 24, 2021·Journal of Pediatric Surgery·Francesca M ShilatiTimothy B Lautz
Sep 7, 2020·The Journal of Surgical Research·Jordan C ApfeldJennifer N Cooper

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