Patients in California and around the country who undergo surgical procedures in low-volume hospitals are more likely to die or encounter complications than patients who are operated on in busier medical facilities. This was the conclusion reached by researchers from U.S. New & World Report after they studied the outcomes of patients who underwent 10 common surgical procedures in both high-volume and low-volume hospitals. The procedures included heart operations, hip and knee replacements and bariatric staple surgery.
The link between surgical mistakes and hospitals with low surgical volumes was first reported by the New England Journal of Medicine in 1979. Patient outcomes in low-volume hospitals are poorer because surgeons who lack practice or experience are more likely to make mistakes. Most low-volume hospitals are located in sparsely populated areas, and their surgeons lack experience because they perform so few surgical procedures.
Health systems set minimum standards
Surgical errors can cost hospitals a lot of money, which may be why three of the nation’s largest health systems have recently introduced experience standards for both hospitals and surgeons. Under these standards, only surgeons and hospitals that have performed a certain number of procedures will be authorized to operate on patients. About 10 million Americans undergo the procedures studied by U.S. New & World report each year, and about 250,000 of them are operated on in low-volume hospitals. Experts believe that more than 1,300 lives would be saved each year if all hospitals introduced experience standards.
Hospitals and doctors have known that surgical errors are more common in low-volume hospitals for decades, but the issue has received little coverage from the mainstream media. U.S. News & World Report conducted its research while developing a new ratings system that will evaluate hospitals based on patient outcomes. Health systems may be implementing changes after years of inaction because they are worried about this kind of transparency.