Volume-Outcomes in Incontinence Surgery

University Of California Los Angeles, Los Angeles CA

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Linked publications & trials

Abstract

DESCRIPTION (provided by applicant): Few studies have examined quality of care in the management of urinary incontinence. Volume, or case load, has been used as a surrogate for quality of care in many diseases and is easily analyzed. Major Hypothesis: Provider volume affects outcomes following pubovaginal sling surgery. Aim 1: To determine whether surgeon volume is associated with short-term outcomes after sling surgery among female Medicare beneficiaries. Aim 2: To determine whether hospital volume is associated with short-term outcomes. Aim 3: To determine whether the interaction between surgeon and hospital volume is associated with short-term outcomes after sling surgery. A 5% national random sample of 1999-2002 claims data from Public Use Files provided by the Centers for Medicare and Medicaid Services will be analyzed. Women undergoing pubovaginal sling procedures will be identified on the basis of the presence of either International Classification of Diseases (ICD-9) codes or Physicians Current Procedural Terminology (CPT-4) codes and tracked for 12 months. The primary outcome will be re-operation rates, repeat sling procedures (for failures), and other postoperative complications, stratified by high and low volume surgeons and hospitals.