Surgeon factors but not hospital factors associated with length of stay after colorectal surgery – A population based study

Aim Length of stay (LOS) after colorectal surgery (CRS) is a significant driver of healthcare utilization and adverse patient outcomes. To date, there is little high‐quality evidence in the literature examining how individual surgeon and hospital factors independently impact LOS. We aimed to identif...

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Veröffentlicht in:Colorectal disease 2023-12, Vol.25 (12), p.2354-2365
Hauptverfasser: Bayat, Zubair, Kennedy, Erin D., Victor, J. Charles, Govindarajan, Anand
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Sprache:eng
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Zusammenfassung:Aim Length of stay (LOS) after colorectal surgery (CRS) is a significant driver of healthcare utilization and adverse patient outcomes. To date, there is little high‐quality evidence in the literature examining how individual surgeon and hospital factors independently impact LOS. We aimed to identify and quantify the independent impact of surgeon and hospital factors on LOS after CRS. Methods A retrospective population‐based cohort study was conducted using validated health administrative databases, encompassing all patients from the province of Ontario, Canada. All patients from 121 hospitals in Ontario who underwent elective CRS between 2008 and 2019 in Ontario were included, and factors pertaining to these patients and their treating surgeon and hospital were assessed. A negative binomial regression model was used to assess the independent effect of surgeon and hospital factors on LOS, accounting for a comprehensive collection of determinants of LOS. To minimize unmeasured confounding, the analysis was repeated in a subgroup comprising patients undergoing lower‐complexity CRS without postoperative complications. Results A total of 90,517 CRS patients were analysed. Independent of patient and procedural factors, low surgeon volume (lowest volume quartile) was associated with a 20% increase in LOS (95% CI: 12–29, p 
ISSN:1462-8910
1463-1318
DOI:10.1111/codi.16794