Can experience improve hospital management?

Haruhisa Fukuda, Kazuhide Okuma, Yuichi Imanaka

研究成果: ジャーナルへの寄稿記事

1 引用 (Scopus)

抄録

Methods: The study sample comprised individuals who had undergone surgery for unruptured abdominal aortic aneurysms and had been discharged from participant hospitals between April 1, 2006 and December 31, 2008. We analyzed the association between case volume (both at the hospital and surgeon level) and postoperative complications using multilevel logistic regression analysis. Multilevel log-linear regression analyses were performed to investigate the associations between case volume and length of stay (LOS) before and after surgery.

Results: We analyzed 909 patients and 849 patients using the hospital-level and surgeon-level analytical models, respectively. The odds ratio of postoperative complication occurrence for an increase of one surgery annually was 0.981 (P< 0.001) at the hospital level and 0.982 (P<0.001) at the surgeon level. The log-linear regression analyses showed that shorter postoperative LOS was significantly associated with high hospital-level case volume (coefficient for an increase of one surgery: 20.006, P= 0.009) and surgeon-level case volume (coefficient for an increase of one surgery: 20.011, P=0.022). Although an increase of one surgery annually at the hospital level was statistically associated with a reduction of preoperative LOS by 1.1% (P =0.006), there was no significant association detected between surgeon-level case volume and preoperative LOS (P=0.504).

Conclusion: Experience at the hospital level may contribute to the improvement of hospital management efficiency.

Background: Experience curve effects were first observed in the industrial arena as demonstrations of the relationship between experience and efficiency. These relationships were largely determined by improvements in management efficiency and quality of care. In the health care industry, volume-outcome relationships have been established with respect to quality of care improvement, but little is known about the effects of experience on management efficiency. Here, we examine the relationship between experience and hospital management in Japanese hospitals.

元の言語英語
記事番号106884
ジャーナルPloS one
9
発行部数9
DOI
出版物ステータス出版済み - 9 24 2014

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Surgery
surgeons
surgery
Length of Stay
postoperative complications
Quality of Health Care
Regression Analysis
Linear regression
Linear Models
Association reactions
aneurysm
Health Care Sector
Abdominal Aortic Aneurysm
Quality Improvement
Health care
Regression analysis
odds ratio
health services
Logistics
Analytical models

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

これを引用

Can experience improve hospital management? / Fukuda, Haruhisa; Okuma, Kazuhide; Imanaka, Yuichi.

:: PloS one, 巻 9, 番号 9, 106884, 24.09.2014.

研究成果: ジャーナルへの寄稿記事

Fukuda, Haruhisa ; Okuma, Kazuhide ; Imanaka, Yuichi. / Can experience improve hospital management?. :: PloS one. 2014 ; 巻 9, 番号 9.
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abstract = "Methods: The study sample comprised individuals who had undergone surgery for unruptured abdominal aortic aneurysms and had been discharged from participant hospitals between April 1, 2006 and December 31, 2008. We analyzed the association between case volume (both at the hospital and surgeon level) and postoperative complications using multilevel logistic regression analysis. Multilevel log-linear regression analyses were performed to investigate the associations between case volume and length of stay (LOS) before and after surgery.Results: We analyzed 909 patients and 849 patients using the hospital-level and surgeon-level analytical models, respectively. The odds ratio of postoperative complication occurrence for an increase of one surgery annually was 0.981 (P< 0.001) at the hospital level and 0.982 (P<0.001) at the surgeon level. The log-linear regression analyses showed that shorter postoperative LOS was significantly associated with high hospital-level case volume (coefficient for an increase of one surgery: 20.006, P= 0.009) and surgeon-level case volume (coefficient for an increase of one surgery: 20.011, P=0.022). Although an increase of one surgery annually at the hospital level was statistically associated with a reduction of preoperative LOS by 1.1{\%} (P =0.006), there was no significant association detected between surgeon-level case volume and preoperative LOS (P=0.504).Conclusion: Experience at the hospital level may contribute to the improvement of hospital management efficiency.Background: Experience curve effects were first observed in the industrial arena as demonstrations of the relationship between experience and efficiency. These relationships were largely determined by improvements in management efficiency and quality of care. In the health care industry, volume-outcome relationships have been established with respect to quality of care improvement, but little is known about the effects of experience on management efficiency. Here, we examine the relationship between experience and hospital management in Japanese hospitals.",
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AB - Methods: The study sample comprised individuals who had undergone surgery for unruptured abdominal aortic aneurysms and had been discharged from participant hospitals between April 1, 2006 and December 31, 2008. We analyzed the association between case volume (both at the hospital and surgeon level) and postoperative complications using multilevel logistic regression analysis. Multilevel log-linear regression analyses were performed to investigate the associations between case volume and length of stay (LOS) before and after surgery.Results: We analyzed 909 patients and 849 patients using the hospital-level and surgeon-level analytical models, respectively. The odds ratio of postoperative complication occurrence for an increase of one surgery annually was 0.981 (P< 0.001) at the hospital level and 0.982 (P<0.001) at the surgeon level. The log-linear regression analyses showed that shorter postoperative LOS was significantly associated with high hospital-level case volume (coefficient for an increase of one surgery: 20.006, P= 0.009) and surgeon-level case volume (coefficient for an increase of one surgery: 20.011, P=0.022). Although an increase of one surgery annually at the hospital level was statistically associated with a reduction of preoperative LOS by 1.1% (P =0.006), there was no significant association detected between surgeon-level case volume and preoperative LOS (P=0.504).Conclusion: Experience at the hospital level may contribute to the improvement of hospital management efficiency.Background: Experience curve effects were first observed in the industrial arena as demonstrations of the relationship between experience and efficiency. These relationships were largely determined by improvements in management efficiency and quality of care. In the health care industry, volume-outcome relationships have been established with respect to quality of care improvement, but little is known about the effects of experience on management efficiency. Here, we examine the relationship between experience and hospital management in Japanese hospitals.

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