[Volume standards: quality through quantity?; relationship between treatment volume and outcomes not well founded]
SourceNederlands Tijdschrift voor Geneeskunde, 157, 33, (2013), pp. A5466
Article / Letter to editor
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Nederlands Tijdschrift voor Geneeskunde
SubjectDCN MP - Plasticity and memory NCEBP 10: Human Movement & Fatigue; NCEBP 4: Quality of hospital and integrated care
- Three domains are accepted as indicators that make the quality of hospital care quantifiable and transparent: process, structure and outcome. - In recent years volume thresholds for surgical interventions have been added as new quality indicators, rendering the assumption that more volume leads to better outcomes. - This assumption has been established for many procedures in peer-reviewed literature since the 1970s. - Although there is consensus about the fact that volume is a proxy measure for other factors influencing the outcome of care, available research does not shed much light on the mechanisms underlying the volume-outcome relationship. - Moreover, the methodological quality of the available research has several limitations. - Despite the incomplete substantiation, volume thresholds are now embedded in 'risk-based' supervision by the health inspectorate as well as purchasing policies by health insurers.
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