AUB ScholarWorks

What would be the effect of referral to high-volume hospitals in a largely rural state?

Show simple item record

dc.contributor.author Ward M.M.
dc.contributor.author Jaana M.
dc.contributor.author Wakefield D.S.
dc.contributor.author Ohsfeldt R.L.
dc.contributor.author Schneider J.E.
dc.contributor.author Miller T.
dc.contributor.author Lei Y.
dc.contributor.editor
dc.date 2004
dc.date.accessioned 2017-10-18T13:35:47Z
dc.date.available 2017-10-18T13:35:47Z
dc.date.issued 2004
dc.identifier 10.1111/j.1748-0361.2004.tb00048.x
dc.identifier.isbn
dc.identifier.issn
dc.identifier.uri http://hdl.handle.net/10938/20587
dc.description.abstract Context: Volume of certain surgical procedures has been linked to patient outcomes. The Leapfrog Group and others have recommended evidence-based referral using specific volume thresholds for nonemergent cases. The literature is limited on the effect of such referral on hospitals, especially in rural areas. Purpose: To examine the impact of evidence-based referral by volume standard for 5 hospital procedures (abdominal aortic artery repair, coronary angioplasty, coronary artery bypass graft, esophageal cancer surgery, and pancreatic resection) in a largely rural state. Methods: Healthcare Cost and Utilization Project Iowa State Inpatient Dataset was analyzed to identify hospitals meeting the volume standard versus those not meeting the standard. Findings: Relatively few hospitals perform these procedures in Iowa. Hospitals performing the procedures at a volume above the threshold standard set by the Leapfrog Group tend to be larger, receive more transfers from other hospitals for these procedures, and perform fewer of these procedures on an emergency basis. In Iowa, hospitals that met the volume standard did not differ from hospitals that did not meet the volume standard in risk-adjusted mortality rates. The impact of evidence-based referral would be substantial in terms of travel time for some procedures (ie, coronary artery bypass graft, pancreatic resection, and esophageal cancer surgery) and produce considerable lost revenue for some hospitals. Conclusions: Evidence-based referral would be associated with substantial burden for some patients and hospitals in Iowa. This negative impact does not appear to be offset by improvement in in-hospital mortality rates. These initial findings suggest that there are a number of issues that need to be considered, especially in a rural state, before evidence-based referral is embraced as a means to enhance patient outcomes.
dc.format.extent
dc.format.extent Pages: (344-354)
dc.language English
dc.publisher KANSAS CITY
dc.relation.ispartof Publication Name: Journal of Rural Health; Publication Year: 2004; Volume: 20; no. 4; special issue SI; Pages: (344-354);
dc.relation.ispartofseries
dc.relation.uri
dc.source Scopus
dc.subject.other
dc.title What would be the effect of referral to high-volume hospitals in a largely rural state?
dc.type Article
dc.contributor.affiliation Ward, M.M., Dept. of Hlth. Management and Policy, University of Iowa, Iowa City, IA, United States, Dept. of Hlth. Management and Policy, College of Public Health, University of Iowa, Iowa City, IA 52242-1008, United States
dc.contributor.affiliation Jaana, M., Dept. of Hlth. Management and Policy, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation Wakefield, D.S., Dept. of Hlth. Management and Policy, University of Iowa, Iowa City, IA, United States
dc.contributor.affiliation Ohsfeldt, R.L., Dept. of Hlth. Management and Policy, University of Iowa, Iowa City, IA, United States
dc.contributor.affiliation Schneider, J.E., Dept. of Hlth. Management and Policy, University of Iowa, Iowa City, IA, United States
dc.contributor.affiliation Miller, T., Dept. of Hlth. Management and Policy, University of Iowa, Iowa City, IA, United States
dc.contributor.affiliation Lei, Y., Dept. of Hlth. Management and Policy, University of Iowa, Iowa City, IA, United States
dc.contributor.authorAddress Ward, M.M.; Dept. of Hlth. Management and Policy, College of Public Health, University of Iowa, Iowa City, IA 52242-1008, United States; email: marcia-m-ward@uiowa.edu
dc.contributor.authorCorporate University: American University of Beirut; Faculty: Faculty of Health Sciences; Department: Health Management and Policy;
dc.contributor.authorDepartment Health Management and Policy
dc.contributor.authorDivision
dc.contributor.authorEmail marcia-m-ward@uiowa.edu
dc.contributor.authorFaculty Faculty of Health Sciences
dc.contributor.authorInitials Ward, MM
dc.contributor.authorInitials Jaana, M
dc.contributor.authorInitials Wakefield, DS
dc.contributor.authorInitials Ohsfeldt, RL
dc.contributor.authorInitials Schneider, JE
dc.contributor.authorInitials Miller, T
dc.contributor.authorInitials Lei, Y
dc.contributor.authorOrcidID
dc.contributor.authorReprintAddress Ward, MM (reprint author), Univ Iowa, Dept Hlth Management and Policy, Iowa City, IA 52242 USA.
dc.contributor.authorResearcherID
dc.contributor.authorUniversity American University of Beirut
dc.description.cited Birkmeyer JD, 2003, NEW ENGL J MED, V349, P2117, DOI 10.1056-NEJMsa035205; Birkmeyer JD, 2003, JAMA-J AM MED ASSOC, V290, P2703, DOI 10.1001-jama.290.20.2703; Birkmeyer JD, 2002, NEW ENGL J MED, V346, P1128, DOI 10.1056-NEJMsa012337; Bosch D, 1997, Caring, V16, P20; CHARLSON ME, 1987, J CHRON DIS, V40, P373, DOI 10.1016-0021-9681(87)90171-8; DHoore W, 1996, J CLIN EPIDEMIOL, V49, P1429, DOI 10.1016-S0895-4356(96)00271-5; Elixhauser A, 2003, HEALTH AFFAIR, V22, P167, DOI 10.1377-hlthaff.22.2.167; Finlayson SRG, 1999, MED CARE, V37, P204, DOI 10.1097-00005650-199902000-00010; Gandjour A, 2003, MED CARE, V41, P1129, DOI 10.1097-01.MLR.0000088301.06323.CA; Halm EA, 2002, ANN INTERN MED, V137, P511; Hillner BE, 2000, J CLIN ONCOL, V18, P2327; Hodgson DC, 2001, J NATL CANCER I, V93, P501, DOI 10.1093-jnci-93.7.501; *IOW HOSP ASS, 2001, PROF; Jencks SF, 2000, JAMA-J AM MED ASSOC, V284, P1670, DOI 10.1001-jama.284.13.1670; LERNER IJ, 1992, CA-CANCER J CLIN, V42, P181, DOI 10.3322-canjclin.42.3.181; LUFT HS, 1987, HEALTH SERV RES, V22, P157; Peterson ED, 2004, JAMA-J AM MED ASSOC, V291, P195, DOI 10.1001-jama.291.2.195; Roberts RR, 1999, JAMA-J AM MED ASSOC, V281, P644, DOI 10.1001-jama.281.7.644; Shahian DM, 2003, ANN THORAC SURG, V75, P1048, DOI 10.1016-S0003-4975(02)04308-4; Sheikh K, 2003, MED CARE, V41, P1111, DOI 10.1097-01.MLR.0000088085.61714.AE; WENNBERG JE, 1989, NEW ENGL J MED, V321, P1168, DOI 10.1056-NEJM198910263211706
dc.description.citedCount 46
dc.description.citedTotWOSCount 45
dc.description.citedWOSCount 45
dc.format.extentCount 11
dc.identifier.articleNo
dc.identifier.coden JRHEE
dc.identifier.pubmedID 15551851
dc.identifier.scopusID 6344258217
dc.identifier.url
dc.publisher.address ONE WEST ARMOUR BLVD, STE 301, KANSAS CITY, MO 64111 USA
dc.relation.ispartofConference
dc.relation.ispartofConferenceCode
dc.relation.ispartofConferenceDate
dc.relation.ispartofConferenceHosting
dc.relation.ispartofConferenceLoc
dc.relation.ispartofConferenceSponsor
dc.relation.ispartofConferenceTitle
dc.relation.ispartofFundingAgency
dc.relation.ispartOfISOAbbr J. Rural Health
dc.relation.ispartOfIssue 4
dc.relation.ispartOfPart
dc.relation.ispartofPubTitle Journal of Rural Health
dc.relation.ispartofPubTitleAbbr J. Rural Health
dc.relation.ispartOfSpecialIssue SI
dc.relation.ispartOfSuppl
dc.relation.ispartOfVolume 20
dc.source.ID WOS:000232016400006
dc.type.publication Journal
dc.subject.otherAuthKeyword
dc.subject.otherChemCAS
dc.subject.otherIndex abdominal aorta
dc.subject.otherIndex aorta surgery
dc.subject.otherIndex article
dc.subject.otherIndex cancer surgery
dc.subject.otherIndex coronary artery bypass graft
dc.subject.otherIndex emergency
dc.subject.otherIndex esophagus cancer
dc.subject.otherIndex health care cost
dc.subject.otherIndex health care utilization
dc.subject.otherIndex hospital care
dc.subject.otherIndex mortality
dc.subject.otherIndex pancreas resection
dc.subject.otherIndex patient referral
dc.subject.otherIndex rural area
dc.subject.otherIndex rural health care
dc.subject.otherIndex surgical technique
dc.subject.otherIndex transluminal coronary angioplasty
dc.subject.otherIndex United States
dc.subject.otherIndex Evidence-Based Medicine
dc.subject.otherIndex Health Care Surveys
dc.subject.otherIndex Hospitals, Rural
dc.subject.otherIndex Humans
dc.subject.otherIndex Iowa
dc.subject.otherIndex Patient Care Team
dc.subject.otherIndex Quality Indicators, Health Care
dc.subject.otherIndex Referral and Consultation
dc.subject.otherIndex Rural Health
dc.subject.otherIndex Safety Management
dc.subject.otherIndex Surgery Department, Hospital
dc.subject.otherIndex Surgical Procedures, Operative
dc.subject.otherKeywordPlus UNITED-STATES
dc.subject.otherKeywordPlus HEALTH-CARE
dc.subject.otherKeywordPlus MEDICARE BENEFICIARIES
dc.subject.otherKeywordPlus OUTCOME RELATIONSHIP
dc.subject.otherKeywordPlus CANCER-TREATMENT
dc.subject.otherKeywordPlus MORTALITY
dc.subject.otherKeywordPlus QUALITY
dc.subject.otherKeywordPlus PATIENT
dc.subject.otherKeywordPlus REGIONALIZATION
dc.subject.otherKeywordPlus SURGERY
dc.subject.otherWOS Health Care Sciences and Services
dc.subject.otherWOS Health Policy and Services
dc.subject.otherWOS Public, Environmental and Occupational Health


Files in this item

Files Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record

Search AUB ScholarWorks


Browse

My Account