• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Neurology

Volume-outcome relationship exists in treatment of intracranial hemorrhage

bys25qthea
December 24, 2012
in Neurology, Public Health, Surgery
Reading Time: 4 mins read
0
Share on FacebookShare on Twitter

[tabs tab1=”2MM Rundown” tab2= “Full 2MM Report” tab3=”About the Authors”]

[tab]

Image: PD/Intracerebral Hemorrhage 

1. Institutions with a greater volume of intracranial hemorrhage cases (>6/year) have superior in-hospital mortality outcomes.

2. There is no volume-cost relationship for intracranial hemorrhage.

Volume-outcome relationships are key drivers of policy with regards to consolidating care for the most complex pathologies at regional institutions with higher case volumes. This study utilized the largest nationally representative all-payer data set to identify a VOR for intracranial hemorrhage that plateaued after 6 cases/year where the in-hospital mortality rate drops from nearly 15% to 8-10%. There was no significant cost-volume relationship identified. The limitations of this study include limited sample size since it only includes 1 year of NIS data, the lack of physiological data in the NIS dataset to control for such clinical parameters between institutions, and the fact that this was a study of institutional volume, not individual surgeon volume which many argue to be more important in determining outcomes.

Click to read the study in Journal of Neurosurgery

RELATED REPORTS

Arterial chemoembolization improves survival in non-resectable hepatocellular carcinoma [Classics Series]

#VisualAbstract: Anti-tau antibody Semorinemab not shown to slow clinical progression of Alzheimer’s disease

United States medical cannabis registration increased significantly between 2016 and 2020

[/tab]

[tab]

Image: PD/Intracerebral Hemorrhage 

1. Institutions with a greater volume of intracranial hemorrhage cases (>6/year) have superior in-hospital mortality outcomes.

2. There is no volume-cost relationship for intracranial hemorrhage.

Primer: The volume-outcome relationship (VOR) in medicine is not only intuitive, but has also been well documented in the literature for numerous procedures, and has led to significant policy changes leading to the consolidation of such practices at high volume centers. A separate, but related issue of the volume-cost relationship has been less clearly established with some studies pointing towards increasing complexity leading to higher costs at high volume centers, while others suggest high volume centers can streamline process measures and improve outcomes leading to ultimate cost reductions. Despite the demonstration of VORs in many areas of medicine, there exists a knowledge gap as to whether there is a VOR for neurotrauma care. The authors of the study were interested in examining this question by focusing on intracranial hemorrhage (ICH) with the hypothesis that low volume centers have inferior outcomes, and high volume centers encounter higher costs.

Background reading:

  1. Bardach NS, Zhao S, Gress DR, Lawton MT, Johnston SC: Association between subarachnoid hemorrhage outcomes and number of cases treated at California hospitals. Stroke 33:1851–1856, 2002.
  2. Birkmeyer JD, Dimick JB: Potential benefits of the new Leapfrog standards: effect of process and outcomes measures. Surgery 135:569–575, 2004.

This [cross sectional cohort ] study: utilized the 2006 Nationwide Inpatient Sample (NIS) to identify patients with intracranial hemorrhage following trauma with ICD-9 codes. Primary outcome measured was patient survival correlated with institutional neurotrauma patient volume.  In-hospital mortality was 14.9% for hospitals with < 6 cases annually vs. less than 10% for hospitals with > 6 cases annually. Rates were similar for centers with 6-11 through 60+ cases/year. Cost of care did not vary significantly with patient volume.

In sum: Volume-outcome relationships are key drivers of policy with regards to consolidating care for the most complex pathologies at regional institutions with higher case volumes. This study utilized the largest nationally representative all-payer data set to identify a VOR for intracranial hemorrhage that plateaued after 6 cases/year where the in-hospital mortality rate drops from nearly 15% to 8-10%. There was no significant cost-volume relationship identified. The limitations of this study include limited sample size since it only includes 1 year of NIS data, the lack of physiological data in the NIS dataset to control for such clinical parameters between institutions, and the fact that this was a study of institutional volume, not individual surgeon volume which many argue to be more important in determining outcomes.

Click to read the study in Journal of Neurosurgery

By [AH] and [MS]

© 2012 2minutemedicine.com. All rights reserved. No works may be reproduced without written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. 

[/tab]

[tab]

Allen Ho: Allen is a 4th year M.D. candidate at Harvard Medical School, currently conducting cancer research at MD Anderson as a Howard Hughes Medical Research Fellow in the laboratory of Ronald DePinho. He attended the University of California, San Diego where he graduated with a Economics degree in 2008, and was a Fulbright Fellow in Nicaragua. He is planning on pursuing a career in neurosurgery. Allen is responsible for editing, writing and steering the direction of the surgery category. His hometown is Irvine, California.

 

[/tab]

[/tabs]

Previous Post

Cow’s milk consumption linked to increased vitamin D, decreased iron in early childhood

Next Post

Hospitals are not exempt from gun violence

RelatedReports

The ABCD2 score: Risk of stroke after Transient Ischemic Attack (TIA) [Classics Series]
Hematology/Oncology Classics

Arterial chemoembolization improves survival in non-resectable hepatocellular carcinoma [Classics Series]

June 29, 2022
#VisualAbstract: Varenicline improves successful smoking cessation amongst African American daily smokers: KIS-IV Trial
StudyGraphics

#VisualAbstract: Anti-tau antibody Semorinemab not shown to slow clinical progression of Alzheimer’s disease

June 29, 2022
Parental cannabis use increasing, cigarette use decreasing
Chronic Disease

United States medical cannabis registration increased significantly between 2016 and 2020

June 29, 2022
#VisualAbstract: Molnupiravir improves outcomes in non-hospitalized COVID-19 patients
StudyGraphics

#VisualAbstract: Phosphodiesterase 4 inhibitor BI 1015550 preserves lung function in pulmonary fibrosis patients

June 29, 2022
Next Post

Hospitals are not exempt from gun violence

Tolvaptan, a vasopressin receptor 2 antagonist, shows promise in polycystic kidney disease (TEMPO trial)

Classics Series, Landmark Trials in Medicine

The ONTARGET trial: Telmisartan is non-inferior to ramipril in improving cardiovascular outcomes in high-risk populations [Classics Series]

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Arterial chemoembolization improves survival in non-resectable hepatocellular carcinoma [Classics Series]
  • #VisualAbstract: Anti-tau antibody Semorinemab not shown to slow clinical progression of Alzheimer’s disease
  • United States medical cannabis registration increased significantly between 2016 and 2020
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.