Annual Repeat Rates of Laparoscopic Surgery: A Marker of Practice Variation

John Jarrell
American journal of medical quality : the official journal of the American College of Medical Quality · 2010 · vol. 25(5) , pp. 378–383 · doi:10.1177/1062860610366588 · PMID:20833984 · W2134200853
article OA: closed CC0 ⤵ 6 in-corpus citations
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This study analyzed administrative data to find that repeat laparoscopic surgery rates vary significantly by individual woman and fiscal year, indicating potential overuse and the need for policy initiatives.

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Abstract

Use of laparoscopy is an area of interest owing to a previous report of significant numbers of repeat laparoscopic surgery in some women in Alberta, Canada. It was hypothesized that analyzing individual-woman rates of annual repeat procedures documents potential overuse of laparoscopic surgery. Administrative data concerning yearly individual specific laparoscopy experiences were obtained from Alberta Health and Wellness for the years 1996 to 2007. Rates of repeat diagnostic and operative laparoscopic procedures were determined for each fiscal year and analyzed using statistical process control methods. The rate of reoperation for an individual woman for both procedures has "special causes" of variation. Rates of reoperation within the fiscal year varied significantly. The reasons could include operating room access, initial clinical enthusiasm for new surgery, changing surgical skills, and changing processes in decision making. The presence of such variation will require policy initiatives to address high rates of annual repeat procedures.

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Condition tags

mesh:D004715

MeSH descriptors

Laparoscopy Practice Patterns, Physicians' Reoperation Alberta Databases, Factual Endometriosis Endometriosis Female Humans Laparoscopy Medical Audit Quality of Health Care Reoperation

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License: CC0 · commercial use OK