Indice
Descrizione indicatore
L’indicatore ci consente di calcolare il numero di interventi chirurgici per tumori maligni al colon eseguiti in un anno in una struttura ospedaliera.
Questo numero rappresenta il "volume" di interventi (indicatore di "
volume").
Come si legge
L’indicatore si riferisce al grado di "
competenza" e di "
sicurezza" delle cure prestate.
Più alto è il numero di interventi chirurgici per tumori maligni al colon eseguiti in una struttura ospedaliera, maggiore è il grado di esperienza della struttura stessa e la sicurezza del trattamento offerto.
Fonte del dato
Programma Nazionale Esiti 2023.
Confronto tra strutture calcolato su dati 2022.
Nota bene: per tener conto di errori nell’attribuzione di condizioni/interventi a singoli ospedali, sono state escluse dalle analisi tutte le strutture con volumi di attività molto bassi in relazione alla condizione considerata (volume di attività minimo
5 casi/anno).
Come riportato nel documento elaborato dal PNE, la definizione dell’esposizione sulla base dei volumi della struttura piuttosto che dell’unità operativa potrebbe essere soggetta a misclassificazione.
Valutazione istituzionale
Il Gruppo di lavoro del Programma Nazionale Esiti ha stabilito che un ospedale dovrebbe eseguire
almeno 45 interventi all’anno per tumore maligno al colon.
Il semaforo è calcolato sulla base del seguente documento ufficiale:
Consulta le strutture sanitarie che effettuano in un anno il maggior numero di interventi chirurgici per tumori al colon Approfondisci anche gli altri indicatori relativi a:
Altre informazioni
Codici ICD-9-CM selezionati
Criteri di eleggibilità
Sono inclusi tutti i ricoveri, in regime ordinario, con diagnosi principale o secondaria di tumore maligno del colon (ICD-9-CM 153,197.5) ed intervento principale o secondario di asportazione parziale dell'intestino crasso o colectomia totale (ICD-9-CM 45.7, 45.8, 45.9, 46.03, 46.04, 46.1).
Il volume di ricoveri per interventi chirurgici è calcolato su base annuale, riferito all’anno di dimissione del ricovero.
Criteri di esclusione
Sono esclusi i ricoveri con intervento principale o secondario di resezione del retto (ICD-9-CM 48.49, 48.5, 48.6).
Fonti scientifiche
- Archampong D, Borowski DW, Dickinson HO. Impact of surgeon volume on outcomes of rectal cancer surgery: a systematic review and meta-analysis. Surgeon 2010;8(6):341-52.
- Archampong D, Borowski D, Wille-Jørgensen P, Iversen LH. Workload and surgeon’s specialty for outcome after colorectal cancer surgery. Cochrane Database Syst Rev 2012;14(3):CD005391.
- van GijnW, Gooiker GA,Wouters MW, Post PN, Tollenaar RA, van de Velde CJ. Volume and outcome in colorectal cancer surgery. Eur J Surg Oncol 2010;36 Suppl 1:S55-63.
- Gruen RL, Pitt V, Green S, Parkhill A, Campbell D, Jolley D. The effect of provider case volume on cancer mortality: systematic review and meta-analysis. CA Cancer J Clin 2009;59(3):192-211.
- Iversen LH, Harling H, Laurberg S, Wille-Jørgensen P. Influence of caseload and surgical speciality on outcome following surgery for colorectal cancer: a review of evidence. Part 1: short-term outcome. Colorectal Dis 2007;9(1):28-37.
- Iversen LH, Harling H, Laurberg S, Wille-Jørgensen P. Influence of caseload and surgical speciality on outcome following surgery for colorectal cancer: a review of evidence. Part 2: long-term outcome. Colorectal Dis 2007;9(1):38-46.
- Killeen SD, O’Sullivan MJ, Coffey JC, Kirwan WO, Redmond HP. Provider volume and outcomes for oncological procedures. Br J Surg 2005;92(4):389-402.
- Hodgson DC, Fuchs CS, Ayanian JZ. Impact of patients and provider characteristics on the treatment and outcomes of colorectal cancer. J Natl Cancer Inst 2001;93(7):501-15.
- Dudley RA, Johansen KL, Brand R, Rennie DJ, Milstein A. Selective referral to high-volume hospitals: estimating potentially avoidable deaths. JAMA 2000; 283(9):1159-66.
- Begg CB, Cramer LD, HoskinsWJ, Brennan MF. Impact of hospital volume on operative mortality for major cancer surgery. JAMA 1998;280(20):1747-51.
- Borowski DW, Kelly SB, Bradburn DM et al. Impact of surgeon volume and specialization on short-term outcomes in colorectal cancer surgery. Br J Surg 2007;94(7):880-89.
- Dimick JB, Cowan JA Jr, Upchurch GR Jr, Colletti LM. Hospital volume and surgical outcomes for elderly patients with colorectal cancer in the United States. J Surg Res 2003;114(1):50-56.
- Engel AF, Oomen JL, Knol DL, Cuesta MA. Operative mortality after colorectal resection in the Netherlands. Br J Surg 2005;92(12):1526-32.
- Fielding LP, Phillips RK, Hittinger R. Factors influencing mortality after curative resection for large bowel cancer in elderly patients. Lancet 1989;1(8638):595-97.
- Galandiuk S, Mahid SS, Polk HC Jr, Turina M, Rao M, Lewis JN. Differences and similarities between rural and urban operations. Surgery 2006;140(4):589-96.
- Harmon JW, Tang DG, Gordon TA et al. Hospital volume can serve as a surrogate for surgeon volume for achieving excellent outcomes in colorectal resection. Ann surg 1999;230(3):404-11; discussion 411-13.
- Hughes RG, Hunt SS, Luft HS. Effects of surgeon volume and hospital volume on quality of care in hospitals. Med Care 1987;25(6):489-503.
- Kee F, Wilson RH, Harper C et al. Influence of hospital and clinician workload on survival from colorectal cancer: cohort study. BMJ 1999;318(7195):1381-85.
- Kelly JV, Hellinger FJ. Physician and hospital factors associated with mortality of surgical patients. Med Care 1986;24(9):785-800.
- Kingston RD, Walsh S, Jeacock J. Colorectal surgeons in district general hospitals produce similar survival outcomes to their teaching hospital colleagues: review of 5-year survivals in Manchester. J R Coll Surg Edinb 1992;37(4):235-37.
- Maerki SC, Luft HS, Hunt SS. Selecting categories of patients for regionalization. Implications of the relationship between volume and outcome. Med Care 1986;24(2):148-58.
- McArdle CS, Hole DJ. Influence of volume and specialization on survival following surgery for colorectal cancer. Br J Surg 2004;91(5):610-17.
- Mella J, Biffin A, Radcliffe AG, Stamatakis JD, Steele RJ. Population-based audit of colorectal cancer management in two UK health regions. Colorectal Cancer Working Group, Royal College of Surgeons of England Clinical Epidemiology and Audit Unit. Br J Surg 1997;84(12):1731-36.
- Parry JM, Collins S, Mathers J, Scott NA, Woodman CB. Influence of volume of work on the outcome of treatment for patients with colorectal cancer. Br J Surg 1999;86(4):475-81.
- Rabeneck L, Davila JA, Thompson M, El-Serag HB. Surgical volume and long-term survival following surgery for colorectal cancer in the Veterans Affairs Health-Care System. Am J Gastroenterol 2004;99(4):668-75.
- Renzulli P, Lowy A, Maibach R, Egeli RA, Metzger U, Laffer UT. The influence of the surgeon’s and the hospital’s caseload on survival and local recurrence after colorectal cancer surgery. Surgery 2006;139(3):296-304.
- Rogers SO Jr, Wolf RE, Zaslavsky AM, Wright WE, Ayanian JZ. Relation of surgeon and hospital volume to processes and outcomes of colorectal cancer surgery. Ann Surg 2006;244(6):1003-11.
- Urbach DR, Bell CM, Austin PC. Differences in operative mortality between high- and low-volume hospitals in Ontario for 5 major surgical procedures: estimating the number of lives potentially saved through regionalization. CMAJ 2003;168(11):1409-14.
- Urbach DR, Baxter NN. Does it matter what a hospital is “high-volume” for? Specificity of hospital volume-outcome associations for surgical procedures: analysis of administrative data. BMJ 2004;328(7442):737-40.
- Zhang W, Ayanian JZ, Zaslavsky AM. Patient characteristics and hospital quality for colorectal cancer surgery. Int J Qual Health Care 2007;19(11):11-20.
