SURGEON'S VOLUME-OUTCOMES RELATIONSHIP FOR LOBECTOMIES AND WEDGE RESECTIONS FOR CANCER USING VIDEO-ASSISTED THORACOSCOPIC TECHNIQUES

• Type of Material: Article
• Authors: Guy David, University of Pennsylvania; Candace Gunnarsson, S2 Statistical Solutions Inc.; Matt Moore, Ethicon Endo-Surgery; John Howington, NorthShore University Health System; Daniel Miller, Emory University; Michael A. Maddaus, University of Minnesota; Robert Joseph McKenna Jr., Cedars Sinai Medical Center; Bryan F. Meyers, Washington University in St. Louis; Scott J. Swanson, Brigham and Women's Hospital
• Language: English
• Date: 2011-05-01
• Publisher: Elsevier Science Inc.
• Publication Version: Final Published Version
• Copyright Statement: © 2012 Guy David et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jval.2011.02.486
• Title of Journal or Parent Work: Minimally Invasive Surgery
• Volume: 14
• Issue: 3
• Start Page: A86
• End Page: A87
• Keywords: Life Sciences & Biomedicine; Health Policy & Services; Business & Economics; Economics; Health Care Sciences & Services; Social Sciences; Science & Technology

Abstract

This study examined the effect of surgeons' volume on outcomes in lung surgery: lobectomies and wedge resections. Additionally, the effect of video-assisted thoracoscopic surgery (VATS) on cost, utilization, and adverse events was analyzed. The Premier Hospital Database was the data source for this analysis. Eligible patients were those of any age undergoing lobectomy or wedge resection using VATS for cancer treatment. Volume was represented by the aggregate experience level of the surgeon in a six-month window before each surgery. A positive volume-outcome relationship was found with some notable features. The relationship is stronger for cost and utilization outcomes than for adverse events; for thoracic surgeons as opposed to other surgeons; for VATS lobectomies rather than VATS wedge resections. While there was a reduction in cost and resource utilization with greater experience in VATS, these outcomes were not associated with greater experience in open procedures.