Journal article
Surgical volume estimates using national or state databases can reasonably disregard missing cases from patients undergoing multiple surgeries on the same day other than for cardiac, vascular, and trauma cases
Perioperative Care and Operating Room Management, Vol.18, p.100084
03/2020
DOI: 10.1016/j.pcorm.2019.100084
Abstract
•Administrative data are often used for estimates of surgery in the United States.•Patients having multiple, separate surgeries on the same day cannot be resolved.•We modeled multiple surgeries in administrative sources with hospital surgical data.•Other than cardiac, vascular, and trauma, the incidence of multiple surgery was low.•For most specialties, undercounting of volume can be ignored in administrative data. Large administrative data sources such as the National Inpatient Sample are frequently used to estimate the incidence of surgery in the United States. These sources do not identify unique surgical cases (often containing multiple procedures). Investigators routinely assume that all surgical procedures on a given day comprise a single case, ignoring returns to the operating room (e.g., to address a complication). We estimated the inaccuracy of this assumption using 11 years of electronic data from 2 large academic hospitals. An administrative database would have underestimated the actual case count by 0.22% (99% UCL = 0.25%) and 0.19% (99% UCL = 0.22%), respectively. Patients undergoing cardiac or vascular surgery had a much greater underestimation of case counts (99% UCL 1.72% and 1.60%, and 99% UCL 1.06% and 1.09%, respectively) than other specialties (99% UCL for each specialty <1.0%, including orthopedics, otolaryngology, and urology). The trauma surgery 99% UCL undercount was 1.7% at the one hospital where this could be measured. For most specialties, inferring overall surgical case frequency using administrative data based on an assumption of no returns to the surgical suite is reasonable. However, adjustment for cardiac, vascular, and trauma surgical caseloads using such sources should be considered.
Details
- Title: Subtitle
- Surgical volume estimates using national or state databases can reasonably disregard missing cases from patients undergoing multiple surgeries on the same day other than for cardiac, vascular, and trauma cases
- Creators
- Richard H Epstein - Department of Anesthesiology, Pain Management and Perioperative Medicine, University of Miami, Miami, FL, USAFranklin Dexter - Division of Management Consulting, Department of Anesthesia, University of Iowa, Iowa City, Iowa, USAJonathan P Wanderer - Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Resource Type
- Journal article
- Publication Details
- Perioperative Care and Operating Room Management, Vol.18, p.100084
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.pcorm.2019.100084
- ISSN
- 2405-6030
- eISSN
- 2405-6030
- Language
- English
- Date published
- 03/2020
- Academic Unit
- Anesthesia; Health Management and Policy
- Record Identifier
- 9983806278402771
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