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Letters |15 June 2004

Hospital Procedure Volume and Outcomes

Ashish V. Joshi, MS; Lesley-Ann Miller, PhD

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  • From Robert C. Byrd Health Sciences Center, Morgantown, WV 26506-9510.
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TO THE EDITOR:
The article by Meyerhardt and colleagues (1) examined the effect of hospital volume on outcomes in patients with colon cancer following resection surgery. The use of clinical trial data rather than administrative claims data strengthened the study because it allowed the researchers to adjust for additional covariates, such as the number of positive lymph nodes, as well as model for recurrences recorded prospectively. The researchers did an excellent job of validating the Medicare procedure volume by comparing it with the Nationwide Inpatient Sample database. The researchers adjusted for any potential “clustering” that may have arisen because of high correlation between outcomes of patients treated by the same surgeon, as referenced in the study by Panageas and colleagues (2), by using a robust sandwich estimator to adjust standard errors for clustering of cases within hospitals.
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Joshi AV, Miller L. Hospital Procedure Volume and Outcomes. Ann Intern Med. ;140:1061–1062. doi: 10.7326/0003-4819-140-12-200406150-00026

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Published: Ann Intern Med. 2004;140(12):1061-1062.

DOI: 10.7326/0003-4819-140-12-200406150-00026

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2004 American College of Physicians
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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