Goldberg Drew, Sharpe James, Bakillah Emna, Landau Sarah, Syvyk Solomiya, Wirtalla Chris, Kelz Rachel
Center for Surgery and Health Economics, University of Pennsylvania, USA; Department of Surgery, Hospital of the University of Pennsylvania, USA.
Center for Surgery and Health Economics, University of Pennsylvania, USA.
Am J Surg. 2025 Jan;239:116017. doi: 10.1016/j.amjsurg.2024.116017. Epub 2024 Oct 23.
Analyzing general surgeons' operative case mix can provide an update on contemporary practice patterns and inform pragmatic residency training.
We performed a retrospective cohort study of general surgeons in Florida, Iowa, and Maryland, 2016-2020. Cases were identified using billing codes. The Cochran-Armitage test of trends was used to evaluate the proportion of practice devoted to specific case types and operative setting over time.
General surgeons (n = 1300) performed 1,287,745 cases. The mean (±SD) annual volume per surgeon for all procedures was 356 (±250), with 198 (±152) general surgery operations, 57 (±142) endoscopic procedures, and 101 (±109) other cases. On average, surgeons operated on 7.1 (±2.6) different organ systems. Trends toward a lower proportion of general surgery operations, and a greater proportion of subspecialty procedures and surgery in the outpatient setting over time were demonstrated (p < 0.001).
The practice pattern of the general surgeon continues to be heterogeneous, reflecting the persistent need for a broad training paradigm that permits specialization.
分析普通外科医生的手术病例组合可以提供当代实践模式的最新情况，并为务实的住院医师培训提供参考。
我们对2016年至2020年佛罗里达州、爱荷华州和马里兰州的普通外科医生进行了一项回顾性队列研究。使用计费代码识别病例。采用 Cochr an-Armitage趋势检验来评估随着时间推移，特定病例类型和手术环境在实践中所占的比例。
普通外科医生（n = 1300）共进行了1287745例手术。所有手术中，每位外科医生的年均手术量为356例（±250），其中普通外科手术198例（±152），内镜手术57例（±142），其他手术101例（±109）。平均而言，外科医生对7.1个（±2.6）不同的器官系统进行手术。随着时间的推移，普通外科手术的比例呈下降趋势，门诊环境下亚专科手术和外科手术的比例呈上升趋势（p < 0.001）。
普通外科医生的实践模式仍然存在差异，这反映出持续需要一种允许专业化的广泛培训模式。
