Measuring the Volume-Outcome Relation for Complex Hospital Surgery

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dc.contributor.authorKim, Woohyeonen_US
dc.contributor.authorWolff, Stephenen_US
dc.contributor.authorHo, Vivianen_US
dc.contributor.orgJames A. Baker III Institute for Public Policyen_US
dc.date.accessioned2016-06-10T16:13:24Zen_US
dc.date.available2016-06-10T16:13:24Zen_US
dc.date.issued2016en_US
dc.description.abstractBackground: Prominent studies continue to measure the hospital volume-outcome relation using simple logistic or random-effects models. These regression models may not appropriately account for unobserved differences across hospitals (such as differences in organizational effectiveness) which could be mistaken for a volume outcome relation. Objective: To explore alternative estimation methods for measuring the volume-outcome relation for six major cancer operations, and to determine which estimation method is most appropriate. Methods: We analyzed patient-level hospital discharge data from three USA states and data from the American Hospital Association Annual Survey of Hospitals from 2000 to 2011. We studied six major cancer operations using three regression frameworks (logistic, fixed-effects, and random-effects) to determine the correlation between patient outcome (mortality) and hospital volume. Results: For our data, logistic and random-effects models suggest a non-zero volume effect, whereas fixed-effects models do not. Model-specification tests support the fixed-effects or random-effects model, depending on the surgical procedure; the basic logistic model is always rejected. Esophagectomy and rectal resection do not exhibit significant volume effects, whereas colectomy, pancreatic resection, pneumonectomy, and pulmonary lobectomy do.en_US
dc.identifier.citationKim, Woohyeon, Wolff, Stephen and Ho, Vivian. "Measuring the Volume-Outcome Relation for Complex Hospital Surgery." <i>Applied Health Economics and Health Policy,</i> (2016) Springer: http://dx.doi.org/10.1007/s40258-016-0241-6.en_US
dc.identifier.doihttp://dx.doi.org/10.1007/s40258-016-0241-6en_US
dc.identifier.urihttps://hdl.handle.net/1911/90474en_US
dc.publisherSpringeren_US
dc.relation.urihttp://bakerinstitute.org/research/measuring-volume-outcome-relation-complex-hospital-surgery/en_US
dc.relation.urihttp://bakerinstitute.org/research/measuring-volume-outcome-relation-complex-hospital-surgery/en_US
dc.rightsThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.en_US
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/en_US
dc.titleMeasuring the Volume-Outcome Relation for Complex Hospital Surgeryen_US
dc.typeJournal articleen_US
dc.type.dcmiTexten_US
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