Gouma Dirk J, Laméris Han J S, Rauws Eric A J, Busch Olivier R C
Academisch Medisch Centrum, Afd. Chirurgie, Amsterdam, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(32):A4887.
The relationship between hospital volume and outcome of care after pancreatic surgery, particularly mortality, has been described extensively in the past. Today, this relationship is frequently being used by healthcare providers and/or insurance companies to select hospitals for various surgical procedures. This concept, however, has many limitations. The conceptual model concerning the relationship between how hospital facilities are arranged and the different aspects of the process of providing healthcare is discussed in three case histories describing complicated postoperative courses after pancreatic resections. The conclusion is that, besides hospital volume, the manner in which the various facilities in hospitals are arranged as well as the process of care giving, particularly the effectiveness of multidisciplinary meetings, are of crucial importance to the quality of care. Data per illness, with adequate correction for case mix, are of crucial importance for comparing the differences in quality of care between hospitals.
过去已对医院手术量与胰腺手术后护理结果（尤其是死亡率）之间的关系进行了广泛描述。如今，医疗服务提供者和/或保险公司经常利用这种关系来为各种外科手术选择医院。然而，这一概念存在许多局限性。在三个描述胰腺切除术后复杂病程的病例中，讨论了关于医院设施布局与医疗服务提供过程不同方面之间关系的概念模型。结论是，除了医院手术量外，医院各种设施的布局方式以及护理过程，尤其是多学科会议的有效性，对护理质量至关重要。针对病例组合进行充分校正的每种疾病的数据，对于比较医院之间护理质量的差异至关重要。
