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Titolo:
Effect of surgical training on outcome and hospital costs in coronary surgery
Autore:
Goodwin, AT; Birdi, I; Ramesh, TPJ; Taylor, GJ; Nashef, SAM; Dunning, JJ; Large, SR;
Indirizzi:
Dept Cardiothorac Surg, Cambridge CB3 8RE, England Dept Cardiothorac SurgCambridge England CB3 8RE bridge CB3 8RE, England Papworth Hosp, Cambridge CB3 8RE, England Papworth Hosp Cambridge England CB3 8RE Hosp, Cambridge CB3 8RE, England MRC, Biostat Unit, Inst Publ Hlth, Cambridge, England MRC Cambridge England Biostat Unit, Inst Publ Hlth, Cambridge, England
Titolo Testata:
HEART
fascicolo: 4, volume: 85, anno: 2001,
pagine: 454 - 457
SICI:
1355-6037(200104)85:4<454:EOSTOO>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Keywords:
coronary artery bypass surgery; training; costs;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
13
Recensione:
Indirizzi per estratti:
Indirizzo: Goodwin, AT Dept Cardiothorac Surg, Papworth Everard, Cambridge CB3 8RE, England Dept Cardiothorac Surg Papworth Everard Cambridge England CB3 8RE
Citazione:
A.T. Goodwin et al., "Effect of surgical training on outcome and hospital costs in coronary surgery", HEART, 85(4), 2001, pp. 454-457

Abstract

Background-There is a perceived conflict between the need for service provision and surgical training within the National Health Service (NHS). Trainee surgeons tend to be slower (thereby reducing theatre throughput), and may have more complications (increasing hospital stay and costs). Objective-To quantify the effect of training on outcome and costs. Design-Data on 2740 consecutive isolated coronary artery bypass (CABG) operations were analysed retrospectively. Redo and emergency procedures were excluded. The seniority of the operating surgeon was related to operating times, risk stratified outcome, and overall hospital costs. Setting-Regional cardiothoracic surgery unit. Main outcome measures-Postoperative mortality; hospital costs. Results-Consultants, senior trainees, intermediate trainees, and junior trainees performed 1524, 759, 434, and 23 procedures, respectively. Trainees at the three different levels were directly supervised by a consultant in 55%, 95%, and 100% of cases. The unadjusted mortalities were 3.2%, 2.0%, 2.3%, and 4.3%, respectively (NS). There were no significant differences between the groups with respect to time in the intensive care unit and length ofhospital stay. The mean cost per patient was pound 6619, pound 6572, pound6494, and pound 6404 (NS). Conclusions-Trainees performed 44.4% of all CABG operations. There was no detrimental effect on patient outcome, length of hospital stay, or overall hospital costs. There need be little conflict between service and training needs, even in hospitals with extensive training programmes.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/01/20 alle ore 13:23:05