Finkler S A
Health Serv Res. 1981 Fall;16(3):325-33.
A recent study concluded that efficient production of heart surgeries requires a minimum volume of 500 procedures per center per year. A replication of that study, under a different set of circumstances, is reported in this paper. The geographic setting was substantially different: a west coast city in the earlier study versus a midwest suburb in the current study. The type of hospital was also substantially different: prepaid health plan-owned in the earlier study versus nonprofit fee-for-service community hospital, owned by a religious order, in the current study. Physician costs were included in the previous study but were excluded from the current study. Travel distances were included in both studies but because of the geographic setting tended to be greater in the current study. The results of the current study indicate that efficient production could be attained at a volume of 300 heart surgery patients per center per year. The difference from the results of the earlier study is attributable to the treatment of physician salaries, the hospital-specific decisions on appropriate capacity and utilization of facilities, and the greater travel distances.
最近的一项研究得出结论，心脏手术的高效开展要求每个中心每年至少进行500例手术。本文报道了在不同情况下对该研究的一次重复。地理环境有很大不同：早期研究是在西海岸城市，而当前研究是在中西部郊区。医院类型也有很大差异：早期研究是由预付健康计划所有，而当前研究是由一个宗教团体所有的非营利性按服务收费社区医院。早期研究纳入了医生成本，但当前研究未纳入。两项研究都纳入了出行距离，但由于地理环境的原因，当前研究中的出行距离往往更长。当前研究结果表明，每个中心每年有300名心脏手术患者时可实现高效开展。与早期研究结果的差异归因于医生薪酬的处理方式、医院关于设施适当容量和利用的特定决策以及更长的出行距离。
