Quantifying the Diversity and Similarity of Surgical Procedures Among Hospitals and Anesthesia Providers

Franklin Dexter; Johannes Ledolter; Bradley J Hindman

doi:10.1213/ANE.0000000000000998

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Quantifying the Diversity and Similarity of Surgical Procedures Among Hospitals and Anesthesia Providers

Journal article

Peer reviewed

Quantifying the Diversity and Similarity of Surgical Procedures Among Hospitals and Anesthesia Providers

Franklin Dexter, Johannes Ledolter and Bradley J Hindman

Anesthesia and analgesia, Vol.122(1), pp.251-263

01/2016

DOI: 10.1213/ANE.0000000000000998

PMID: 26678472

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Abstract

In this Statistical Grand Rounds, we review methods for the analysis of the diversity of procedures among hospitals, the activities among anesthesia providers, etc. We apply multiple methods and consider their relative reliability and usefulness for perioperative applications, including calculations of SEs. We also review methods for comparing the similarity of procedures among hospitals, activities among anesthesia providers, etc. We again apply multiple methods and consider their relative reliability and usefulness for perioperative applications. The applications include strategic analyses (e.g., hospital marketing) and human resource analytics (e.g., comparisons among providers). Measures of diversity of procedures and activities (e.g., Herfindahl and Gini-Simpson index) are used for quantification of each facility (hospital) or anesthesia provider, one at a time. Diversity can be thought of as a summary measure. Thus, if the diversity of procedures for 48 hospitals is studied, the diversity (and its SE) is being calculated for each hospital. Likewise, the effective numbers of common procedures at each hospital can be calculated (e.g., by using the exponential of the Shannon index). Measures of similarity are pairwise assessments. Thus, if quantifying the similarity of procedures among cases with a break or handoff versus cases without a break or handoff, a similarity index represents a correlation coefficient. There are several different measures of similarity, and we compare their features and applicability for perioperative data. We rely extensively on sensitivity analyses to interpret observed values of the similarity index.

Data Interpretation, Statistical

Humans

Patient Handoff - trends

Anesthesia Department, Hospital - trends

Surgical Procedures, Operative - statistics & numerical data

Models, Statistical

Quality Indicators, Health Care - statistics & numerical data

Anesthesiology - statistics & numerical data

Practice Patterns, Physicians' - trends

Anesthesiology - trends

Practice Patterns, Physicians' - statistics & numerical data

Regression Analysis

Likelihood Functions

Anesthesia Department, Hospital - statistics & numerical data

Quality Indicators, Health Care - trends

Surgical Procedures, Operative - trends

Details

Title: Subtitle: Quantifying the Diversity and Similarity of Surgical Procedures Among Hospitals and Anesthesia Providers
Creators: Franklin Dexter - From the Division of Management Consulting, Department of Anesthesia; †Department of Management Sciences; and ‡Department of Anesthesia, University of Iowa, Iowa City, Iowa
Johannes Ledolter
Bradley J Hindman
Resource Type: Journal article
Publication Details: Anesthesia and analgesia, Vol.122(1), pp.251-263
Publisher: United States
DOI: 10.1213/ANE.0000000000000998
PMID: 26678472
ISSN: 0003-2999
eISSN: 1526-7598
Language: English
Date published: 01/2016
Academic Unit: Statistics and Actuarial Science; Health Management and Policy; Anesthesia; Business Analytics
Record Identifier: 9983805904302771

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