Minimum volume standards in day surgery: a systematic review
- PDF / 671,597 Bytes
- 17 Pages / 595.276 x 790.866 pts Page_size
- 92 Downloads / 216 Views
(2020) 20:886
RESEARCH ARTICLE
Open Access
Minimum volume standards in day surgery: a systematic review Michal Stanak1,2*
and Christoph Strohmaier1
Abstract Background: The aim was to find out if and for what indications are minimum volume standards (MVS) applied in the day surgery setting and whether the application of MVS improves patient relevant outcomes. Methods: We conducted a comprehensive systematic literature search in seven databases on July 12th, 2019. Concerning effectiveness and safety, the data retrieved from the selected studies were systematically extracted into data-extraction tables. Two independent researchers (MS, CS) systematically assessed the quality of evidence using the quality assessment tool for individual studies of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) called Task Force Checklist for Quality Assessment of Retrospective Database Studies. No instances of disagreement occurred. No further data processing was applied. Results: The systematic literature search, together with hand search, yielded 595 hits. No prospective or controlled studies were found. Data from eight retrospective studies were used in the analysis of clinical effectiveness and safety on seven indications: anterior cruciate ligament reconstruction, cataract surgery, meniscectomy, thyroidectomy, primary hip arthroscopy, open carpal tunnel release, and rotator cuff repair. All interventions (except for carpal tunnel release and thyroidectomy) confirmed a volume-outcome relationship (VOR) with relation to surgeon/hospital volume, however, none established MVS for the respective interventions. Safety related data were reported without its relationship to surgeon/hospital volume. Conclusions: This present paper provides some evidence in favor of the VOR, however, it based on low quality retrospective data-analyses. The present results cannot offer any clear-cut MVS thresholds for the day surgery setting and so the simple transition from inpatient results (that support MVS) to the day surgery setting is questionable. Further quality assuring policy approaches should be considered.
Background Definition of day surgery
The International Association for Ambulatory Surgery (IAAS) defines day surgery as a practice where patients are admitted, operated on, and discharged during the time frame of one working day (6 to 8 h), with no overnight stay [1]. The EU observatory as well as the British Association for Day Surgery (BADS) further add that true day surgery includes planned non-emergency * Correspondence: [email protected] 1 Austrian Institute for Health Technology Assessment (former Ludwig Boltzmann Institute for Health Technology Assessment), Vienna, Austria 2 Department of Philosophy, University of Vienna, Vienna, Austria
surgical procedures on carefully-selected and prepared patients that are intended to be treated in the day surgery setting [2, 3]. Because some procedures may require longer recovery or observation, in order to keep them as day surgeries, they have to be
Data Loading...
