Osmanski-Zenk Katrin, Klinder Annett, Pingsmann Andreas, Lohmann Christoph H, Bail Hermann Josef, Kladny Bernd, Mittelmeier Wolfram
Orthopedic Clinic and Policlinic, University Rostock Medical Center, 18057 Rostock, Germany.
Professional Association for Orthopaedics and Trauma Surgery, Biberburg Orthopaedic Associates, 14089 Berlin, Germany.
Healthcare (Basel). 2024 Apr 26;12(9):904. doi: 10.3390/healthcare12090904.
To improve arthroplasty care quality, the EndoCert initiative focuses on structural, processual, and surgeon-related quality assurance. The aim of this study was to assess the impact of a surgeon's case load in certified centers on quality of care, distinguished by different types of surgeons. Data from the annual reports of EndoCert certified centers for the years 2017 to 2021 were analyzed. The study revealed reduced numbers of cases, while the number of surgeons remained constant. Since 2020, the decrease in the average case load per surgeons has become more pronounced. There were also differences between senior (sECrs) and EndoCert-registered surgeons (ECrs). Before the 2020 pandemic, over half of surgeons exceeded minimum annual case requirements, while, afterwards, this number declined, especially for the ECrs. Affiliated surgeons, who are also sECrs or ECrs, performed predominantly lower numbers of arthroplasties. However, a higher percentage of affiliated surgeons in a center correlated with faster surgeries and lower mortality rates. High numbers of arthroplasties per center or surgeon were not necessarily associated with better quality indicators, especially in the knee. While the comprehensive quality standards may offset volume effects, EndoCert should reconsider minimum volume regulations based on surgeon, but also on each joint.
为提高关节成形术的护理质量，EndoCert计划专注于结构、流程以及与外科医生相关的质量保证。本研究的目的是评估认证中心外科医生的病例量对护理质量的影响，并按不同类型的外科医生进行区分。分析了EndoCert认证中心2017年至2021年年度报告中的数据。研究显示病例数量减少，而外科医生的数量保持不变。自2020年以来，每位外科医生平均病例量的下降更为明显。资深（sECrs）外科医生和EndoCert注册外科医生（ECrs）之间也存在差异。在2020年疫情之前，超过一半的外科医生超过了年度最低病例要求，而此后，这一数字下降，尤其是对于ECrs而言。同时身为sECrs或ECrs的附属外科医生进行的关节成形术数量主要较少。然而，一个中心中附属外科医生的比例较高与手术速度更快和死亡率更低相关。每个中心或外科医生进行大量关节成形术并不一定与更好的质量指标相关，尤其是在膝关节方面。虽然综合质量标准可能抵消手术量的影响，但EndoCert应重新考虑基于外科医生以及每个关节的最低手术量规定。
