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PubMed · 10247528

Hospital building: sizing up the size problem.

S Halpern
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Abstract

Political dogma or an attempt to bring hospital services closer to the people? The Government's policy on hospital size as expressed in a new consultation paper is sure to be controversial; Stephen Halpern looks at the proposals and their implications for hospital staff, patients and the NHS.

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Health Facility SizeHospital Bed CapacityHospital PlanningUnited KingdomJournal Article

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S Halpern. 1980-06-06. Hospital building: sizing up the size problem.. https://pubmed.ncbi.nlm.nih.gov/10247528/

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Provider volume and outcomes for oncological procedures.

BACKGROUND: Oncological procedures may have better outcomes if performed by high-volume providers. METHODS: A review of the English language literature incorporating searches of the Medline, Embase and Cochrane collaboration databases was performed. Studies were included if they involved a patient cohort from 1984 onwards, were community or population based, and assessed health outcome as a dependent variable and volume as an independent variable. The studies were also scored quantifiably to assess generalizability with respect to any observed volume-outcome relationship and analysed according to organ system; numbers needed to treat were estimated where possible. RESULTS: Sixty-eight relevant studies were identified and a total of 41 were included, of which 13 were based on clinical data. All showed either an inverse relationship, of variable magnitude, between provider volume and mortality, or no volume-outcome effect. All but two clinical reports revealed a statistically significant positive relationship between volume and outcome; none demonstrated the opposite. CONCLUSION: High-volume providers have a significantly better outcome for complex cancer surgery, specifically for pancreatectomy, oesphagectomy, gastrectomy and rectal resection.

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