Can experience improve hospital management?
BACKGROUND: Experience curve effects were first observed in the industrial arena as demonstrations of the relationship between experience and efficiency. These relationships were largely determined by improvements in management efficiency and quality of care. In the health care industry, volume-outc...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4175069?pdf=render |
| _version_ | 1819195669136539648 |
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| author | Haruhisa Fukuda Kazuhide Okuma Yuichi Imanaka |
| author_facet | Haruhisa Fukuda Kazuhide Okuma Yuichi Imanaka |
| author_sort | Haruhisa Fukuda |
| collection | DOAJ |
| description | BACKGROUND: Experience curve effects were first observed in the industrial arena as demonstrations of the relationship between experience and efficiency. These relationships were largely determined by improvements in management efficiency and quality of care. In the health care industry, volume-outcome relationships have been established with respect to quality of care improvement, but little is known about the effects of experience on management efficiency. Here, we examine the relationship between experience and hospital management in Japanese hospitals. METHODS: The study sample comprised individuals who had undergone surgery for unruptured abdominal aortic aneurysms and had been discharged from participant hospitals between April 1, 2006 and December 31, 2008. We analyzed the association between case volume (both at the hospital and surgeon level) and postoperative complications using multilevel logistic regression analysis. Multilevel log-linear regression analyses were performed to investigate the associations between case volume and length of stay (LOS) before and after surgery. RESULTS: We analyzed 909 patients and 849 patients using the hospital-level and surgeon-level analytical models, respectively. The odds ratio of postoperative complication occurrence for an increase of one surgery annually was 0.981 (P < 0.001) at the hospital level and 0.982 (P < 0.001) at the surgeon level. The log-linear regression analyses showed that shorter postoperative LOS was significantly associated with high hospital-level case volume (coefficient for an increase of one surgery: -0.006, P = 0.009) and surgeon-level case volume (coefficient for an increase of one surgery: -0.011, P = 0.022). Although an increase of one surgery annually at the hospital level was statistically associated with a reduction of preoperative LOS by 1.1% (P = 0.006), there was no significant association detected between surgeon-level case volume and preoperative LOS (P = 0.504). CONCLUSION: Experience at the hospital level may contribute to the improvement of hospital management efficiency. |
| first_indexed | 2024-12-23T02:16:26Z |
| format | Article |
| id | doaj.art-7d7c15f66adb4ef6b65ae072a16ea5e5 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-23T02:16:26Z |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-7d7c15f66adb4ef6b65ae072a16ea5e52022-12-21T18:03:39ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0199e10688410.1371/journal.pone.0106884Can experience improve hospital management?Haruhisa FukudaKazuhide OkumaYuichi ImanakaBACKGROUND: Experience curve effects were first observed in the industrial arena as demonstrations of the relationship between experience and efficiency. These relationships were largely determined by improvements in management efficiency and quality of care. In the health care industry, volume-outcome relationships have been established with respect to quality of care improvement, but little is known about the effects of experience on management efficiency. Here, we examine the relationship between experience and hospital management in Japanese hospitals. METHODS: The study sample comprised individuals who had undergone surgery for unruptured abdominal aortic aneurysms and had been discharged from participant hospitals between April 1, 2006 and December 31, 2008. We analyzed the association between case volume (both at the hospital and surgeon level) and postoperative complications using multilevel logistic regression analysis. Multilevel log-linear regression analyses were performed to investigate the associations between case volume and length of stay (LOS) before and after surgery. RESULTS: We analyzed 909 patients and 849 patients using the hospital-level and surgeon-level analytical models, respectively. The odds ratio of postoperative complication occurrence for an increase of one surgery annually was 0.981 (P < 0.001) at the hospital level and 0.982 (P < 0.001) at the surgeon level. The log-linear regression analyses showed that shorter postoperative LOS was significantly associated with high hospital-level case volume (coefficient for an increase of one surgery: -0.006, P = 0.009) and surgeon-level case volume (coefficient for an increase of one surgery: -0.011, P = 0.022). Although an increase of one surgery annually at the hospital level was statistically associated with a reduction of preoperative LOS by 1.1% (P = 0.006), there was no significant association detected between surgeon-level case volume and preoperative LOS (P = 0.504). CONCLUSION: Experience at the hospital level may contribute to the improvement of hospital management efficiency.http://europepmc.org/articles/PMC4175069?pdf=render |
| spellingShingle | Haruhisa Fukuda Kazuhide Okuma Yuichi Imanaka Can experience improve hospital management? PLoS ONE |
| title | Can experience improve hospital management? |
| title_full | Can experience improve hospital management? |
| title_fullStr | Can experience improve hospital management? |
| title_full_unstemmed | Can experience improve hospital management? |
| title_short | Can experience improve hospital management? |
| title_sort | can experience improve hospital management |
| url | http://europepmc.org/articles/PMC4175069?pdf=render |
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