Provider caseload-volume and short-term outcomes following colorectal surgeries in New Brunswick: Results from a provincial-level cohort study | UNB

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Provider caseload-volume and short-term outcomes following colorectal surgeries in New Brunswick: Results from a provincial-level cohort study

Author: Dan L. Crouse, Jonathan Boudreau, Philip S.J. Leonard, Keith Pawluk, James T. McDonald
Year: 2020
Category: Health Publications

Read the journal article in the Canadian Journal of Surgery

Background

American studies have shown that higher provider and hospital volumes are associated with reduced risk of mortality following colorectal surgical interventions. Evidence from Canada is limited, and to our knowledge only a single study has considered outcomes other than death. We describe associations between provider surgical volume and all-cause mortality and postoperative complications following colorectal surgical interventions in New Brunswick.

Results

Overall, 9170 interventions were performed by 125 providers across 18 hospitals. We found decreased odds of experiencing a complication following colorectal surgery per increment of 10 interventions performed per year (odds ratio 0.94, 95% confidence interval 0.91–0.96). We found no associations with mortality. Associations remained consistent across models restricted to cancer patients or to interventions performed by general surgeons and across models that also considered overall hospital volumes.

Conclusion

Our results suggest that increased caseloads are associated with reduced odds of complications, but not with all-cause mortality, following colorectal surgery in New Brunswick. We also found no evidence of volume having differential effects on outcomes from colon and rectal procedures.

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