Profiles of institutional departments affect operative outcomes of eight gastroenterological procedures

Annals of Gastroenterological Surgery

Arata Takahashi¹  Hiroaki Miyata¹  Hiraku Kumamaru²  Kinji Kamiya³  Yoshihiro Kakeji⁴  Shigeru Marubashi⁴  Hiroyuki Konno⁴  Kenichi Hakamada⁵  Yasuyuki Seto⁵ 

[1] Department of Health Policy and Management School of Medicine Keio University Tokyo Japan;Department of Healthcare Quality Assessment Graduate School of Medicine The University of Tokyo Tokyo Japan;Second Department of Surgery Hamamatsu University School of Medicine Hamamatsu Japan;The Japanese Society of Gastroenterological Surgery Database Committee Tokyo Japan;The Japanese Society of Gastroenterological Surgery Tokyo Japan;

关键词: National clinical database;    observed to expected (O/E) operative mortality ratio;    operative mortality;    profiles of institutional departments;    questionnaire;   

DOI  :  10.1002/ags3.12431

来源: DOAJ

【 摘 要 】

Abstract Aim We evaluated the association of profiles of institutional departments with operative outcomes of eight major gastroenterological procedures. Methods We administered a 15‐item online survey to 2634 institutional departments in 2016 to investigate the association of questionnaire responses with operative mortality for the procedures. The proportions of conditions met were listed according to institutional volume and classified according to annual operative cases in 1464 departments. Group A included departments with annual performance of <40 cases of the eight procedures, B 40‐79 cases, C 80‐199 cases, D 200‐499 cases, and E ≥ 500 cases. We evaluated the number of conditions met for 10 of 15 items that could be improved by efforts of institutional departments, to assess whether the profiles of institutional departments had impacts on operative mortality. We built a multivariable logistic regression model for operative mortality with facilities categorized based on the number of conditions met and procedure‐specific predicted mortality as explanatory variables using generalized estimating equation to account for facility‐level clustering. We also examined how operative outcomes differed between facilities meeting nine or more conditions and those that did not. Results We recognized meeting nine out of the 10 conditions as being a good indicator for having appropriate structural and process measures for gastroenterological surgery. The facilities meeting nine or more of the conditions had better operative mortality for all eight procedures. Conclusions Our findings reveal that the profiles of institutional departments can reflect the outcomes of gastroenterological surgery in Japan.

【 授权许可】

Unknown