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An Analysis Of Shoulder Surgeon Volume On Competency, Hospital Costs And Adverse Events: A Systematic Review

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An Analysis Of Shoulder Surgeon Volume On Competency, Hospital Costs And Adverse Events: A Systematic Review

Moin Khan, MD, MSc, FRCSC, CANADA Haseeb Ahmed Faisal, BHSc(Cand), CANADA Ajaykumar Shanmugaraj, BSc, CANADA Shahrukh Khan, BHSc, CANADA Loiy Alkhatib , MD, UNITED ARAB EMIRATES Mahdi Alsaffar, KUWAIT Timothy Leroux, MD, MEd, FRCSC, CANADA

McMaster University , Hamilton, Ontario, CANADA


2023 Congress   ePoster Presentation   2023 Congress   Not yet rated

 

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Summary: The aim of this systematic review is to provide the most up to date assessment of the impact of shoulder surgeon volume of common shoulder procedures on hospital/surgical efficiency, adverse events, and hospital costs. It is hypothesized that a higher surgeon volume will lead to better hospital/surgeon efficiency, lower rates of adverse events and lower hospital costs.


Purpose

The purpose of this systematic review is to assess the impact of shoulder surgeon volume of common shoulder procedures on hospital/surgeon efficiency, adverse events, and hospital costs.

Methods

Four online databases (PubMed, Embase, MEDLINE and CENTRAL) were searched for literature on the influence of surgeon volume on outcomes for shoulder surgery, from data inception to October 1, 2020. The Methodological Index for Non-Randomized Studies tool was used to assess study quality. Data are presented descriptively.

Results

12 studies encompassing 150898 patients were included in this review. The distribution of surgery type was rotator cuff repair (53.7%; n = 81066), shoulder arthroplasty (35.7%; n = 53833), and ORIF (10.6%; n = 15999). Higher surgeon volume for rotator cuff repairs was associated with lower surgical time, length of stay, costs, and reoperation/readmission rates (p < 0.01). For shoulder arthroplasty, higher surgeon volume was associated with lower length of stay, costs, surgical time, non-routine disposition, blood loss, reoperation/readmission, and complications (p < 0.08). As for ORIF, higher surgeon volume was associated with lower length of stay, costs, and complications (p < 0.01).

Conclusion

A high-surgeon volume leads to improved results for hospital/surgeon efficiency, adverse events, and hospital costs across various orthopaedic procedures. Hospitals and physicians can use this information to develop and adhere to policies and practices that contribute to more efficient and better-quality care for patients.


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