Abstract
Objective
To determine whether statistical differences occur in total cost, length of stay, ICU days, and surgical complications, depending on the volume of laryngectomy procedures performed.
Methods
Secondary laryngectomy data from 108 hospitals participating in the University Health System Consortium was examined. All laryngectomy surgical cases occurring from July 1, 2001, through June 30, 2005, with an ICD-9 code of 30.3 or 30.4 were analyzed (N=4,551). The cases were divided into 3 categories based on the number of surgical laryngectomy cases performed by hospital. Those volume categories were high, as defined by organizations with 100–233 cases (n=1712); medium, between 60–99 cases (n=1353); and low, between 4–59 cases (n=1458). 4 dependent variables were examined including total cost, length of stay, ICU days, and complications.
Results
The 4 dependent variables were analyzed for normality by performing a Kolmogorov-Smirnov test. All 4 variables were non-normally distributed. A Kruskal-Wallis test was then performed on each variable to determine if a statistically significant difference appeared between the 3 volume categories. Each variable was found to have statistical significant differences between the groups, with the high volume hospitals having the lowest cost, shortest length of stay, shortest ICU days, and smallest complication rate.
Conclusions
This study showed that hospitals with higher surgeon volume for total laryngectomies had reduced total cost, length of stay, number of ICU days, and complication rate for their patients.
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