Volume and Outcome
To the Editor: The attempt of Birkmeyer et al. (April 11 issue) 1 to correlate low procedure-specific hospital volume with increased mortality has methodologic and interpretive problems. The investigators used data from the Medicare Provider Analysis and Review (excluding those for Medicare patients...
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| Veröffentlicht in: | The New England journal of medicine 2002-08, Vol.347 (9), p.693-696 |
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| container_issue | 9 |
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| container_title | The New England journal of medicine |
| container_volume | 347 |
| creator | Barone, James E Risucci, Donald A Savino, John A |
| description | To the Editor:
The attempt of Birkmeyer et al. (April 11 issue)
1
to correlate low procedure-specific hospital volume with increased mortality has methodologic and interpretive problems. The investigators used data from the Medicare Provider Analysis and Review (excluding those for Medicare patients enrolled in health maintenance organizations) and from the Nationwide Inpatient Sample, without verification, to estimate procedure-specific hospital volume. The correlation between Medicare volume and hospital volume (correlation coefficient, 0.97) probably resulted from mathematic coupling,
2
,
3
which occurs when variables are shared. Were the relations between outcome and volume significant when only Medicare volumes were analyzed?
No proof of . . . |
| doi_str_mv | 10.1056/NEJM200208293470918 |
| format | Article |
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The attempt of Birkmeyer et al. (April 11 issue)
1
to correlate low procedure-specific hospital volume with increased mortality has methodologic and interpretive problems. The investigators used data from the Medicare Provider Analysis and Review (excluding those for Medicare patients enrolled in health maintenance organizations) and from the Nationwide Inpatient Sample, without verification, to estimate procedure-specific hospital volume. The correlation between Medicare volume and hospital volume (correlation coefficient, 0.97) probably resulted from mathematic coupling,
2
,
3
which occurs when variables are shared. Were the relations between outcome and volume significant when only Medicare volumes were analyzed?
No proof of . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJM200208293470918</identifier><identifier>PMID: 12200565</identifier><language>eng</language><publisher>United States: Massachusetts Medical Society</publisher><subject>Aged ; Confounding Factors (Epidemiology) ; Hospital Mortality ; Hospitals - utilization ; Humans ; Medicare ; Outcome Assessment (Health Care) ; Regression Analysis ; Surgical Procedures, Operative - mortality ; Surgical Procedures, Operative - utilization ; United States - epidemiology</subject><ispartof>The New England journal of medicine, 2002-08, Vol.347 (9), p.693-696</ispartof><rights>Copyright © 2002 Massachusetts Medical Society. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c591t-2d45e026c4ff00208a0a9f68935d0f439fb348781a002d5566184b0b0f55c16b3</citedby><cites>FETCH-LOGICAL-c591t-2d45e026c4ff00208a0a9f68935d0f439fb348781a002d5566184b0b0f55c16b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.nejm.org/doi/pdf/10.1056/NEJM200208293470918$$EPDF$$P50$$Gmms$$H</linktopdf><linktohtml>$$Uhttps://www.nejm.org/doi/full/10.1056/NEJM200208293470918$$EHTML$$P50$$Gmms$$H</linktohtml><link.rule.ids>314,776,780,2746,2747,26080,27901,27902,52357,54039</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12200565$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Barone, James E</creatorcontrib><creatorcontrib>Risucci, Donald A</creatorcontrib><creatorcontrib>Savino, John A</creatorcontrib><title>Volume and Outcome</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>To the Editor:
The attempt of Birkmeyer et al. (April 11 issue)
1
to correlate low procedure-specific hospital volume with increased mortality has methodologic and interpretive problems. The investigators used data from the Medicare Provider Analysis and Review (excluding those for Medicare patients enrolled in health maintenance organizations) and from the Nationwide Inpatient Sample, without verification, to estimate procedure-specific hospital volume. The correlation between Medicare volume and hospital volume (correlation coefficient, 0.97) probably resulted from mathematic coupling,
2
,
3
which occurs when variables are shared. Were the relations between outcome and volume significant when only Medicare volumes were analyzed?
No proof of . . .</description><subject>Aged</subject><subject>Confounding Factors (Epidemiology)</subject><subject>Hospital Mortality</subject><subject>Hospitals - utilization</subject><subject>Humans</subject><subject>Medicare</subject><subject>Outcome Assessment (Health Care)</subject><subject>Regression Analysis</subject><subject>Surgical Procedures, Operative - mortality</subject><subject>Surgical Procedures, Operative - utilization</subject><subject>United States - epidemiology</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkr1PwzAQxS0EoqWwsCKhTiwocP62R1SVLxW6AKvlJLbUKm5K3Az895i2EgtCvsXD_d678-khdIHhBgMXt6_T5xcCQEARTZkEjdUBGmJOacEYiEM0TE1VMKnpAJ3EuIRUmOljNMAkCbngQ3T-0TZ9cGO7qsfzflO1wZ2iI2-b6M727wi930_fJo_FbP7wNLmbFRXXeFOQmnEHRFTM--0WFqz2QmnKa_CMal9SpqTCNnVrzoXAipVQgue8wqKkI3S181137Wfv4saERaxc09iVa_toJAHGBIc8EFOdBVKdLpQFYpk3mjDIcwQlWCZIsj5Dpdyeh-7Aqmtj7Jw3624RbPdlMJifpJg_kpJUl3v7vgyu_tXso5GA6x0QQjQrtwz_2n0Dojm-yA</recordid><startdate>20020829</startdate><enddate>20020829</enddate><creator>Barone, James E</creator><creator>Risucci, Donald A</creator><creator>Savino, John A</creator><general>Massachusetts Medical Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20020829</creationdate><title>Volume and Outcome</title><author>Barone, James E ; Risucci, Donald A ; Savino, John A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c591t-2d45e026c4ff00208a0a9f68935d0f439fb348781a002d5566184b0b0f55c16b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Aged</topic><topic>Confounding Factors (Epidemiology)</topic><topic>Hospital Mortality</topic><topic>Hospitals - utilization</topic><topic>Humans</topic><topic>Medicare</topic><topic>Outcome Assessment (Health Care)</topic><topic>Regression Analysis</topic><topic>Surgical Procedures, Operative - mortality</topic><topic>Surgical Procedures, Operative - utilization</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barone, James E</creatorcontrib><creatorcontrib>Risucci, Donald A</creatorcontrib><creatorcontrib>Savino, John A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The New England journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Barone, James E</au><au>Risucci, Donald A</au><au>Savino, John A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Volume and Outcome</atitle><jtitle>The New England journal of medicine</jtitle><addtitle>N Engl J Med</addtitle><date>2002-08-29</date><risdate>2002</risdate><volume>347</volume><issue>9</issue><spage>693</spage><epage>696</epage><pages>693-696</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><abstract>To the Editor:
The attempt of Birkmeyer et al. (April 11 issue)
1
to correlate low procedure-specific hospital volume with increased mortality has methodologic and interpretive problems. The investigators used data from the Medicare Provider Analysis and Review (excluding those for Medicare patients enrolled in health maintenance organizations) and from the Nationwide Inpatient Sample, without verification, to estimate procedure-specific hospital volume. The correlation between Medicare volume and hospital volume (correlation coefficient, 0.97) probably resulted from mathematic coupling,
2
,
3
which occurs when variables are shared. Were the relations between outcome and volume significant when only Medicare volumes were analyzed?
No proof of . . .</abstract><cop>United States</cop><pub>Massachusetts Medical Society</pub><pmid>12200565</pmid><doi>10.1056/NEJM200208293470918</doi><tpages>4</tpages></addata></record> |
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| identifier | ISSN: 0028-4793 |
| ispartof | The New England journal of medicine, 2002-08, Vol.347 (9), p.693-696 |
| issn | 0028-4793 1533-4406 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_72044650 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; New England Journal of Medicine |
| subjects | Aged Confounding Factors (Epidemiology) Hospital Mortality Hospitals - utilization Humans Medicare Outcome Assessment (Health Care) Regression Analysis Surgical Procedures, Operative - mortality Surgical Procedures, Operative - utilization United States - epidemiology |
| title | Volume and Outcome |
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