Arndt M, Bradbury R C, Golec J H
Master of Health Administration Program, Graduate School of Management, Clark University, Worcester, MA 01610, USA.
Inquiry. 1995;32(4):407-17.
This study examines whether surgeons who perform a particular procedure more often incur lower hospital charges and shorter lengths of stay than surgeons with less volume. The 43 Pennsylvania hospitals included in the 1991 MedisGroups Comparative Hospital Database form the study hospitals. The analysis looks at four frequently occurring surgical procedures: cholecystectomy, prostatectomy, hysterectomy, and intervertebral disc excision. Regression models are estimated separately for total charges, ancillary charges, and length of stay for each surgical procedure. The explanatory variable of interest is surgeon volume for the specific procedure. Control variables include patient age, sex, admission severity of illness, insurance plan, and hospital. For cholecystectomy, prostatectomy, and intervertebral disc surgery, we find a significant negative association between surgeon volume and both hospital charges and length of stay. We find no such volume effect for hysterectomy. The paper discusses management and policy implications of these findings.
本研究考察了与手术量较少的外科医生相比，更频繁地进行特定手术的外科医生是否会产生更低的住院费用和更短的住院时间。1991年医疗集团比较医院数据库中纳入的宾夕法尼亚州43家医院构成了研究医院。该分析着眼于四种常见的外科手术：胆囊切除术、前列腺切除术、子宫切除术和椎间盘切除术。针对每种外科手术的总费用、辅助费用和住院时间分别估计回归模型。感兴趣的解释变量是特定手术的外科医生手术量。控制变量包括患者年龄、性别、入院时的疾病严重程度、保险计划和医院。对于胆囊切除术、前列腺切除术和椎间盘手术，我们发现外科医生手术量与住院费用和住院时间之间存在显著的负相关关系。对于子宫切除术，我们未发现这种手术量效应。本文讨论了这些研究结果的管理和政策意义。
