Abstract
PURPOSE OF REVIEW: Monitoring and improving the quality of healthcare is an evolving process that involves patients, physicians, and healthcare purchasers. Growing interest is seen in addressing quality concerns with policy changes. Surgeon and hospital volumes for specific high-risk procedures have been shown to be predictive of posttreatment outcome, but debate continues as to if the evidence justifies changes in practices. We reviewed the literature for robust evidence that surgeon and hospital volumes are markers of improved outcome of radical cystectomy. RECENT FINDINGS: Outcome can be measured by postoperative mortality, as well as complication rate, recurrence rate, and several other factors. Evidence suggests that outcome is improved after cystectomy performed at high-volume centers and by high-volume surgeons. The limitations of volume-based referral policies are discussed, and the use of alternative strategies is reviewed. SUMMARY: A significant regionalization of cystectomy has already been established. Owing to their limitations, however, volume-based referral systems have not been embraced by all parties. New strategies will continue to evolve, and validation of these strategies will be required before clinical implementation.
Original language | English (US) |
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Pages (from-to) | 344-349 |
Number of pages | 6 |
Journal | Current opinion in urology |
Volume | 16 |
Issue number | 5 |
DOIs | |
State | Published - Sep 2006 |
Keywords
- Hospital volume
- Outcome assessment
- Radical cystectomy
- Surgeon volume
ASJC Scopus subject areas
- Urology