Abstract:
BACKGROUND:The "practice makes perfect" concept considers the more frequent a hospital performs a procedure, the better the outcome of the procedure. We aimed to study this concept by investigating whether patient outcomes improve in hospitals with a significantly increased volume of high-risk surgery over time and whether a learning effect existed at the individual hospital level. METHODS:We included all patients who underwent one of 10 digestive, cardiovascular and orthopaedic procedures between 2010 and 2014 from the French nationwide hospitals database. For each procedure, we identified three groups of hospitals according to volume trend (increased, decreased, or no change). In-hospital mortality, reoperation, and unplanned hospital readmission within 30 days were compared between groups using Cox regressions, taking into account clustering of patients within hospitals and potential confounders. Individual hospital learning effect was investigated by considering the interaction between hospital groups and procedure year. RESULTS:Over 5 years, 759,928 patients from 694 hospitals were analysed. Patients' mortality in hospitals with procedure volume increase or decrease over time did not clearly differ from those in hospitals with unchanged volume across the studied procedures (e.g., Hazard Ratios [95%] of 1.04 [0.93-1.17] and 1.08 [0.97-1.21] respectively for colectomy). Furthermore, patient outcomes did not improve or deteriorate in hospitals with increased or decreased volume of procedures over time (e.g., 1.01 [0.95-1.08] and 0.99 [0.92-1.05] respectively for colectomy). CONCLUSIONS:Trend in hospital volume over time did not appear to influence patient outcomes based on real-world data. TRIAL REGISTRATION:NCT02788331, June 2, 2016.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Payet C,Polazzi S,Lifante JC,Cotte E,Grinberg D,Carty MJ,Sanchez S,Rabilloud M,Duclos Adoi
10.1186/s12913-020-05126-4subject
Has Abstractpub_date
2020-04-01 00:00:00pages
274issue
1issn
1472-6963pii
10.1186/s12913-020-05126-4journal_volume
20pub_type
杂志文章abstract:BACKGROUND:Healthcare providers operate in a unique industry characterized by pursuit of perhaps the most noble of missions: the delivery of vital health and medical services to those in need. Distinguishing features abound, differentiating the healthcare industry from others, with such facets having the potential to c...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2342-9
更新日期:2017-07-11 00:00:00
abstract:OBJECTIVE:While most studies focused on the relation between volunteering and health-related outcomes, little attention has been given on the association between volunteering and the use of health care services. Thus, with this analysis we aimed at exploring whether and how the voluntary work of older adults is related...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-3867-x
更新日期:2019-01-15 00:00:00
abstract:BACKGROUND:Partnerships between clinicians and researchers could increase the generalizability of research findings and increase uptake of research results across populations. Yet engaging clinicians in research is challenging. Clinical Data Research Networks (CDRNs) provide access to a broad array of clinical data, pa...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3399-9
更新日期:2018-07-20 00:00:00
abstract:BACKGROUND:Care coordination has increasingly been recognized as an important aspect of high-quality health care delivery. Robust measures of coordination processes will be essential tools to evaluate, guide and support efforts to understand and improve coordination, yet little agreement exists among stakeholders about...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/1472-6963-13-119
更新日期:2013-03-28 00:00:00
abstract:BACKGROUND:Integrated care is the coordination of general and behavioral health and is a highly promising and practical approach to improving healthcare delivery and patient outcomes. While there is growing interest and investment in integrated care implementation internationally, there are no formal guidelines for int...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4661-5
更新日期:2019-11-27 00:00:00
abstract:BACKGROUND:Chronic low back pain (CLBP) is a highly prevalent condition that has substantial impact on patients, the healthcare system and society. Pain management services (PMS), which aim to address the complex nature of back pain, are recommended in clinical practice guidelines to manage CLBP. Although the effective...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-5013-1
更新日期:2020-03-12 00:00:00
abstract:BACKGROUND:Systematic reviews of randomised placebo controlled trials of antidepressant medication show small and decreasing differences between pharmacological and placebo arms. In part this finding may relate to methodological problems with conventional trial designs, including their assumption of additivity between ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-7-64
更新日期:2007-04-30 00:00:00
abstract:BACKGROUND:Tissue engineering is an emerging field. Novel bioengineered skin substitutes and genetically derived growth factors offer innovative approaches to reduce the burden of diabetic foot and venous leg ulcers for both patients and health care systems. However, they frequently are very costly. Based on a systemat...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/1472-6963-9-115
更新日期:2009-07-10 00:00:00
abstract:BACKGROUND:Substantial government funding has been invested to support the training of General Practitioners (GPs) in Australia to serve rural communities. However, there is little data on the impact of this expanded training on smaller communities, particularly for smaller rural and more remote communities. Improved u...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05684-7
更新日期:2020-08-31 00:00:00
abstract:BACKGROUND:Falls are very common accidents in a hospital. Various risk factors and risk assessment tools are used to predict falls. However, outcomes of falls such as bone fractures have not been considered in these risk assessment tools, and the performance of risk assessment tools in a Japanese hospital setting is no...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-10-106
更新日期:2010-04-27 00:00:00
abstract:BACKGROUND:In 2000, midwifery was regulated in the Canadian Province of Manitoba. Since the establishment of the midwifery program, little formal research has analyzed the utilization of regulated midwifery services. In Manitoba, the demand for midwifery services has exceeded the number of midwives in practice. The spe...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1334-5
更新日期:2016-03-15 00:00:00
abstract:BACKGROUND:Global coronary heart disease (CHD) risk assessment is recommended to guide primary preventive pharmacotherapy. However, little is known about physicians' understanding and use of global CHD risk assessment. Our objective was to examine US physicians' awareness, use, and attitudes regarding global CHD risk a...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-20
更新日期:2012-01-24 00:00:00
abstract:BACKGROUND:Australia has a universal health care system and a comprehensive safety net. Despite this, outcomes for Australians living in rural and remote areas are worse than those living in cities. This study will examine the current state of equity of access to birthing services for women living in small communities ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2084-8
更新日期:2017-02-23 00:00:00
abstract:BACKGROUND:Since 2003 and 2005, National Pilot Medical Financial Assistance Scheme (MFA) has been implemented in rural and urban areas of China to improve the poorest families' accessibility to health services. Local governments of the pilot areas formulated various benefit packages. Comparative evaluation research on ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-10-170
更新日期:2010-06-17 00:00:00
abstract:BACKGROUND:Despite continued investment, Maternal, Newborn and Child Health (MNCH) indicators in low and middle income countries have remained relatively poor. This could, in part, be explained by inadequate resources to adequately address these problems, inappropriate allocation of the available resources, or lack of ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4170-6
更新日期:2019-07-08 00:00:00
abstract:BACKGROUND:While the benefits or otherwise of early hip fracture repair is a long-running controversy with studies showing contradictory results, this practice is being adopted as a quality indicator in several health care organizations. The aim of this study is to analyze the association between early hip fracture rep...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-15
更新日期:2012-01-18 00:00:00
abstract:BACKGROUND:In the Netherlands, ethnic minority populations visit their general practitioner (GP) more often than the indigenous population. An explanation for this association is lacking. Recently, health literacy is suggested as a possible explaining mechanism. Internationally, associations between health literacy and...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2276-2
更新日期:2017-05-15 00:00:00
abstract:BACKGROUND:Potentially avoidable hospitalizations represent an indirect measure of access to effective primary care. However many approaches have been proposed to measure them and results may differ considerably. This work aimed at examining the agreement between the Weissman and Ansari approaches in order to measure p...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-014-0661-7
更新日期:2015-01-22 00:00:00
abstract:BACKGROUND:General practitioners (GPs) adopt clinical practice guidelines to varying degrees. Several factors have been found to influence application of guidelines in practice and the GP is apparently the key actor. Studies are needed to increase our understanding of how GPs' attitudes influence their use of guideline...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-218
更新日期:2008-10-22 00:00:00
abstract:BACKGROUND:The effects of tobacco, physical exercise, diet, and alcohol consumption on morbidity and mortality underline the importance of health promotion and prevention (HPP) at the primary health care (PHC) level. Likewise, the deficiencies when putting such policies into practice and assessing their effectiveness a...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-62
更新日期:2011-03-23 00:00:00
abstract:BACKGROUND:The implementation of strategic health system change is often complicated by the informal politics and power of health systems, such as competing interests and resistant groups. Evidence from other industries shows that strategic leaders need to be aware of and manage such 'organisational politics' when impl...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3728-z
更新日期:2018-12-03 00:00:00
abstract:BACKGROUND:A novel point-of-care ultrasound (PoCUS) training program was developed to train rural healthcare providers in Kenya on the Focused Assessment with Sonography for Trauma (FAST), thoracic ultrasound, basic echocardiography, and focused obstetric ultrasonography. The program includes a multimedia manual, pre-c...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3196-5
更新日期:2018-08-06 00:00:00
abstract:BACKGROUND:Home-visiting nurses are expected to enhance their ability to provide adequate nursing care in a relatively isolated work environment. However, the isolated work environment leads to less opportunity to share patient information. We investigated factors relevant to better patient information sharing among ho...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-3924-5
更新日期:2019-02-04 00:00:00
abstract:BACKGROUND:E-mental health is a promising medium to keep mental health affordable and accessible. For consumers with severe mental illness the evidence of the effectiveness of e-health is limited. A number of difficulties and barriers have to be addressed concerning e-health for consumers with severe mental illness. On...
journal_title:BMC health services research
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12913-016-1267-z
更新日期:2016-01-19 00:00:00
abstract:BACKGROUND:When it was initiated in 2001, England's national patient survey programme was one of the first in the world and has now been widely emulated in other healthcare systems. The aim of the survey programme was to make the National Health Service (NHS) more "patient centred" and more responsive to patient feedba...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-71
更新日期:2012-03-21 00:00:00
abstract:BACKGROUND:Venous thromboembolism (VTE) prophylaxis in an important aspect of the care of hospitalised patients, for which the National Institute for Health and Care Excellence (NICE) has issued guidance. Guidance compliance continues to be a concern. Junior doctors are the main group responsible for prescribing thromb...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1480-9
更新日期:2016-07-15 00:00:00
abstract:BACKGROUND:Previous self-harm is one of the strongest predictors of future self-harm and suicide. Increased risk of repeated self-harm and suicide exists amongst patients presenting to hospital with high-risk self-harm and major self-harm repeaters. However, so far evidence-based training in the management of self-harm...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05254-x
更新日期:2020-06-22 00:00:00
abstract:BACKGROUND:Costs and consumer preference have led to a shift from the long-term institutional care of aged older people to home and community based care. The aim of this review is to evaluate the outcomes of case managed, integrated or consumer directed home and community care services for older persons, including thos...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/1472-6963-11-93
更新日期:2011-05-09 00:00:00
abstract:BACKGROUND:Hospital treatment for hip fracture is complex, often involving sequential episodes for acute orthopaedics, rehabilitation and care of contingent conditions. Most reports of hospital length of stay (LOS) address only the acute phase of care. This study identifies the frequency and mean duration of the compon...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-0697-3
更新日期:2015-01-22 00:00:00
abstract:BACKGROUND:Having a tax-funded and supposedly 'National' Health Service (NHS), one might assume that the UK is well-positioned to roll out eHealth innovations at scale. Yet, despite a strong policy push, the English NHS has been limited in the extent to which it has exploited the potential of eHealth. MAIN BODY:This p...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/s12913-019-4790-x
更新日期:2019-12-21 00:00:00