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BackgroundThe study aimed to explore the impact of surgeon and institution volume on outcome following colorectal surgery in England using multilevel hierarchical analysis.
MethodsAn observational study design was used. All patients undergoing primary elective colorectal resection between 2000 and 2008 were included from the Hospital Episode Statistics database. Consultant surgeons and hospitals were divided into tertiles (low, medium and high volume) according to their mean annual colorectal cancer resection caseload. Outcome measures examined were postoperative 30‐day mortality, 28‐day readmission and reoperation, and length of stay. Hierarchical multiple regression analysis adjusted for age, sex, co‐morbidity, social deprivation, year of surgery, operation type and surgical approach....
BackgroundThere is increasing evidence of variable standards of care for patients undergoing emergency general surgery in the National Health Service (NHS). The aim of this study was to quantify and explore variability in mortality amongst high‐risk emergency general surgery admissions to English NHS hospital Trusts.
MethodsThe Hospital Episode Statistics (HES) database was used to identify high‐risk emergency general surgery diagnoses (greater than 5 per cent national 30‐day mortality rate). Adults admitted to English NHS Trusts with these diagnoses between 2000 and 2009 were included in the study. Thirty‐day in‐hospital mortality was adjusted for patient and hospital factors. Trusts were grouped into high‐ and low‐mortality outliers, and resource availability was compared between high‐ and low‐mortality outlier institutions...
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