High Volume Hospitals and Discharge to Home after Colon Surgery

MedicalResearch.com Interview with:
Daniel A. Anaya, MD, FACS
Associate Professor of Surgery – Surgical Oncology
Michael E. DeBakey Department of Surgery
Baylor College of Medicine
Chief, General Surgery & Surgical Oncology SectionDirector, Liver Tumor Program
Michael E. DeBakey VA Medical Center Houston, TX 77030

Dr. Courtney J. Balentine, MD
First author and surgical resident at Baylor College of Medicine

MedicalResearch.com: What are the main findings of the study?

Dr. Anaya:  That a good proportion of patients having colorectal operations will need additional assistance to recover during the postoperative period, resulting in being discharged to other facilities (nursing facilities, skilled care, etc) after surgery, and that hospitals where a higher-volume of colorectal operations are performed are more likely to discharge patients back to home after surgery.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Balentine:   We did expect that higher volume hospitals would be more likely to get patients home after surgery but the magnitude of the difference was still a surprise.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Balentine:

For clinicians:  when referring your patients for surgery, not only is it important to look at how well your surgeons perform by traditional quality measures (morbidity and mortality, but also whether your patients are really making it home and recovering the ability to function independently after surgery.

For patients:  it’s important to realize that surgery is a difficult process that often takes quite a while to recover from.  Even hospitals that do a lot of surgery and have very good outcomes still often need to send their patients to a short or long term care facility to help with recovery.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Anaya:  We plan to explore what features of high volume hospitals allow better rates of discharge to home.  Once we identify important differences in practice between high and low volume centers we can help all hospitals do a better job of helping patients to get home after surgery. We are also exploring patient features associated to higher chance of needing care during the recovery period. We have found that older patients are at increased risk and are working on better understanding what conditions, in addition to age alone, can help predict and anticipate those needs. Our overall goal is to be able to understand the different factors affecting the recovery period and the ability for a given patient to regain functional independence after surgery.


Association of High-Volume Hospitals With Greater Likelihood of Discharge to Home Following Colorectal Surgery

Balentine CJ, Naik AD, Robinson CN, et al. Association of High-Volume Hospitals With Greater Likelihood of Discharge to Home Following Colorectal Surgery. JAMA Surg. 2014;():. doi:10.1001/jamasurg.2013.3838.

Last Updated on June 4, 2015 by Marie Benz MD FAAD