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Title of Journal: Knee Surg Sports Traumatol Arthrosc

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Abbravation: Knee Surgery, Sports Traumatology, Arthroscopy

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Springer-Verlag

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DOI

10.1002/ejsp.2420170406

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ISSN

1433-7347

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Effect of provider volume on resource utilization

Authors: Nitin Jain Ricardo Pietrobon Ulrich Guller Anoop Shankar Ajit S Ahluwalia Laurence D Higgins
Publish Date: 2004/08/04
Volume: 13, Issue: 4, Pages: 302-312
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Abstract

Operatingroom time and patient disposition on discharge are important determinants of healthcare resource utilization and cost We examined the relation between these determinants and hospital/surgeon volume for anterior cruciate ligament ACL reconstruction and meniscectomy procedures Patients undergoing ACL reconstruction 18390 cases and meniscectomy 123012 cases were extracted from the State Ambulatory Surgery Databases for the years 1997–2000 Surgeon and hospital volume were divided into low intermediate and highvolume categories Multivariate logistic regression models were used to estimate the adjusted association between surgeon and hospital volume and patient discharge status and operatingroom time Patients undergoing ACL reconstruction or meniscectomy performed by lowvolume surgeons were significantly more likely to be nonroutinely discharged as compared to highvolume surgeons adjusted odds ratio 35 95 confidence interval 17–72 for ACL reconstruction adjusted odds ratio 20 95 confidence interval 16–23 for meniscectomy The mean operatingroom time for performing ACL reconstruction or meniscectomy was significantly higher in low and intermediatevolume surgeons and hospitals as compared to highvolume surgeons and hospitals p≤0001 Highvolume providers utilize healthcare resources more efficiently Our findings may help surgeons and hospitals in optimizing resource utilization and cost for routinelyperformed ambulatory surgery procedures

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  13. The effect of notchplasty in anterior cruciate ligament reconstruction: a biomechanical study in the porcine knee
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  16. Staged protocol for initial management of the dislocated knee
  17. The future is in our hands
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