Document Detail


Appropriateness variation in cholecystectomy.
MedLine Citation:
PMID:  15369029     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cholecystectomy use varies moderately across regions and countries. The purpose of this study was to evaluate the appropriateness of the use of cholecystectomy in patients with nonmalignant diseases in different hospitals using explicit criteria developed by an expert panel. METHODS: Patients on waiting lists to undergo a cholecystectomy for nonmalignant diseases in six public hospitals in Spain were included in this prospective observational study over a 1-year period. Appropriateness criteria were first developed by a panel of experts using the RAND appropriateness method. The appropriateness of the indication was judged by applying explicit criteria developed previously. Complications were recorded 3 months after surgery. RESULTS: After evaluation of 960 patients, 7 (0.7%) were considered to have undergone inappropriate procedures and 76 (7.9%) were judged to be uncertain. Differences were found in the rate of appropriateness among some centres (inappropriateness rate ranging from to 0 to 2.6%). No differences were found among the appropriateness categories for length of stay or complications, mortality, or readmission up to the third month after discharge. CONCLUSIONS: This study identified a low percentage of inappropriately performed cholecystectomies in our area. Even so, appropriateness differences among hospitals were found.
Authors:
José M Quintana; José Cabriada; Ignacio López de Tejada; Luis Perdigo; Inmaculada Aróstegui; Amaia Bilbao; Idoia Garay
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of public health     Volume:  14     ISSN:  1101-1262     ISO Abbreviation:  Eur J Public Health     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-09-16     Completed Date:  2004-10-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9204966     Medline TA:  Eur J Public Health     Country:  England    
Other Details:
Languages:  eng     Pagination:  252-7     Citation Subset:  IM    
Affiliation:
Unidad de Investigación, Hospital de Galdakao, Galdakao, Vizcaya, Spain. jmquinta@hgda.osakidetza.net
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Analysis of Variance
Cholangiopancreatography, Endoscopic Retrograde
Cholecystectomy / utilization*
Cholelithiasis / diagnosis,  radiography,  surgery*
Diabetes Complications
Female
Health Services Research
Humans
Length of Stay
Logistic Models
Male
Middle Aged
Odds Ratio
Patient Readmission
Postoperative Complications
Prospective Studies
Risk Factors
Spain
Time Factors
Utilization Review

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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