@article{mehta_relative_2016,
	title = {Relative impact of surgeon and hospital volume on operative mortality and complications following pancreatic resection in {Medicare} patients},
	volume = {204},
	issn = {1095-8673},
	doi = {10.1016/j.jss.2016.05.008},
	abstract = {BACKGROUND: Surgeon and hospital volume are both known to affect outcomes for patients undergoing pancreatic resection. The objective was to evaluate the relative effects of surgeon and hospital volume on 30-d mortality and 30-d complications after pancreatic resection among older patients.
MATERIALS AND METHODS: The study used Texas Medicare data (2000-2012), identifying high-volume surgeons as those performing ≥4 pancreatic resections/year, and high-volume hospitals as those performing ≥11 pancreatic resections/year, on Medicare patients. Three-level hierarchical logistic regression models were used to evaluate the relative effects of surgeon and hospital volumes on mortality and complications, after adjusting for case mix differences.
RESULTS: There were 2453 pancreatic resections performed by 490 surgeons operating in 138 hospitals. Of the total, 4.5\% of surgeons and 6.5\% of hospitals were high volume. The overall 30-d mortality was 9.0\%, and the 30-d complication rate was 40.6\%. Overall, 8.9\% of the variance in 30-d mortality was attributed to surgeon factors and 9.8\% to hospital factors. For 30-d complications, 4.7\% of the variance was attributed to surgeon factors and 1.2\% to hospital factors. After adjusting for patient, surgeon, and hospital characteristics, high surgeon volume (odds ratio [OR] = 0.54, 95\% confidence interval [CI], 0.33-0.87) and high hospital volume (OR = 0.52; 95\% CI, 0.30-0.92) were associated with lower risk of mortality; high surgeon volume (OR = 0.71, 95\% CI, 0.55-0.93) was also associated lower risk of 30-d complications.
CONCLUSIONS: Both hospital and surgeon factors contributed significantly to the observed variance in mortality, but only surgeon factors impacted complications.},
	language = {eng},
	number = {2},
	journal = {The Journal of Surgical Research},
	author = {Mehta, Hemalkumar B. and Parmar, Abhishek D. and Adhikari, Deepak and Tamirisa, Nina P. and Dimou, Francesca and Jupiter, Daniel and Riall, Taylor S.},
	month = aug,
	year = {2016},
	pmid = {27565068},
	pmcid = {PMC5002309},
	keywords = {Complications, Hospital volume, Mortality, Multilevel models, Pancreatic resection, Surgeon volume},
	pages = {326--334},
}

{"_id":"x5ypawGG84YMyAyYe","bibbaseid":"mehta-parmar-adhikari-tamirisa-dimou-jupiter-riall-relativeimpactofsurgeonandhospitalvolumeonoperativemortalityandcomplicationsfollowingpancreaticresectioninmedicarepatients-2016","downloads":0,"creationDate":"2017-01-16T00:21:59.605Z","title":"Relative impact of surgeon and hospital volume on operative mortality and complications following pancreatic resection in Medicare patients","author_short":["Mehta, H. B.","Parmar, A. D.","Adhikari, D.","Tamirisa, N. P.","Dimou, F.","Jupiter, D.","Riall, T. S."],"year":2016,"bibtype":"article","biburl":"http://bibbase.org/zotero/hbmehta","bibdata":{"bibtype":"article","type":"article","title":"Relative impact of surgeon and hospital volume on operative mortality and complications following pancreatic resection in Medicare patients","volume":"204","issn":"1095-8673","doi":"10.1016/j.jss.2016.05.008","abstract":"BACKGROUND: Surgeon and hospital volume are both known to affect outcomes for patients undergoing pancreatic resection. The objective was to evaluate the relative effects of surgeon and hospital volume on 30-d mortality and 30-d complications after pancreatic resection among older patients. MATERIALS AND METHODS: The study used Texas Medicare data (2000-2012), identifying high-volume surgeons as those performing ≥4 pancreatic resections/year, and high-volume hospitals as those performing ≥11 pancreatic resections/year, on Medicare patients. Three-level hierarchical logistic regression models were used to evaluate the relative effects of surgeon and hospital volumes on mortality and complications, after adjusting for case mix differences. RESULTS: There were 2453 pancreatic resections performed by 490 surgeons operating in 138 hospitals. Of the total, 4.5% of surgeons and 6.5% of hospitals were high volume. The overall 30-d mortality was 9.0%, and the 30-d complication rate was 40.6%. Overall, 8.9% of the variance in 30-d mortality was attributed to surgeon factors and 9.8% to hospital factors. For 30-d complications, 4.7% of the variance was attributed to surgeon factors and 1.2% to hospital factors. After adjusting for patient, surgeon, and hospital characteristics, high surgeon volume (odds ratio [OR] = 0.54, 95% confidence interval [CI], 0.33-0.87) and high hospital volume (OR = 0.52; 95% CI, 0.30-0.92) were associated with lower risk of mortality; high surgeon volume (OR = 0.71, 95% CI, 0.55-0.93) was also associated lower risk of 30-d complications. CONCLUSIONS: Both hospital and surgeon factors contributed significantly to the observed variance in mortality, but only surgeon factors impacted complications.","language":"eng","number":"2","journal":"The Journal of Surgical Research","author":[{"propositions":[],"lastnames":["Mehta"],"firstnames":["Hemalkumar","B."],"suffixes":[]},{"propositions":[],"lastnames":["Parmar"],"firstnames":["Abhishek","D."],"suffixes":[]},{"propositions":[],"lastnames":["Adhikari"],"firstnames":["Deepak"],"suffixes":[]},{"propositions":[],"lastnames":["Tamirisa"],"firstnames":["Nina","P."],"suffixes":[]},{"propositions":[],"lastnames":["Dimou"],"firstnames":["Francesca"],"suffixes":[]},{"propositions":[],"lastnames":["Jupiter"],"firstnames":["Daniel"],"suffixes":[]},{"propositions":[],"lastnames":["Riall"],"firstnames":["Taylor","S."],"suffixes":[]}],"month":"August","year":"2016","pmid":"27565068","pmcid":"PMC5002309","keywords":"Complications, Hospital volume, Mortality, Multilevel models, Pancreatic resection, Surgeon volume","pages":"326–334","bibtex":"@article{mehta_relative_2016,\n\ttitle = {Relative impact of surgeon and hospital volume on operative mortality and complications following pancreatic resection in {Medicare} patients},\n\tvolume = {204},\n\tissn = {1095-8673},\n\tdoi = {10.1016/j.jss.2016.05.008},\n\tabstract = {BACKGROUND: Surgeon and hospital volume are both known to affect outcomes for patients undergoing pancreatic resection. The objective was to evaluate the relative effects of surgeon and hospital volume on 30-d mortality and 30-d complications after pancreatic resection among older patients.\nMATERIALS AND METHODS: The study used Texas Medicare data (2000-2012), identifying high-volume surgeons as those performing ≥4 pancreatic resections/year, and high-volume hospitals as those performing ≥11 pancreatic resections/year, on Medicare patients. Three-level hierarchical logistic regression models were used to evaluate the relative effects of surgeon and hospital volumes on mortality and complications, after adjusting for case mix differences.\nRESULTS: There were 2453 pancreatic resections performed by 490 surgeons operating in 138 hospitals. Of the total, 4.5\\% of surgeons and 6.5\\% of hospitals were high volume. The overall 30-d mortality was 9.0\\%, and the 30-d complication rate was 40.6\\%. Overall, 8.9\\% of the variance in 30-d mortality was attributed to surgeon factors and 9.8\\% to hospital factors. For 30-d complications, 4.7\\% of the variance was attributed to surgeon factors and 1.2\\% to hospital factors. After adjusting for patient, surgeon, and hospital characteristics, high surgeon volume (odds ratio [OR] = 0.54, 95\\% confidence interval [CI], 0.33-0.87) and high hospital volume (OR = 0.52; 95\\% CI, 0.30-0.92) were associated with lower risk of mortality; high surgeon volume (OR = 0.71, 95\\% CI, 0.55-0.93) was also associated lower risk of 30-d complications.\nCONCLUSIONS: Both hospital and surgeon factors contributed significantly to the observed variance in mortality, but only surgeon factors impacted complications.},\n\tlanguage = {eng},\n\tnumber = {2},\n\tjournal = {The Journal of Surgical Research},\n\tauthor = {Mehta, Hemalkumar B. and Parmar, Abhishek D. and Adhikari, Deepak and Tamirisa, Nina P. and Dimou, Francesca and Jupiter, Daniel and Riall, Taylor S.},\n\tmonth = aug,\n\tyear = {2016},\n\tpmid = {27565068},\n\tpmcid = {PMC5002309},\n\tkeywords = {Complications, Hospital volume, Mortality, Multilevel models, Pancreatic resection, Surgeon volume},\n\tpages = {326--334},\n}\n\n","author_short":["Mehta, H. 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