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Teaching hospitals have lower death rates for certain surgical procedures

Patient Safety Monitor Alert, February 11, 2004

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Death rates for some complex gastrointestinal surgical procedures are lower at teaching hospitals than at non-teaching hospitals, according to an article in the February issue of The Archives of Surgery ("Hospital Teaching Status and Outcomes of Complex Surgical Procedures in the United States," Vol. 139, No. 2).

Justin B. Dimick, MD, of the University of Michigan Medical Center, Ann Arbor, and colleagues compared surgical outcomes at teaching and non-teaching hospitals and the association between hospital volume and teaching status for three complex gastrointestinal surgical procedures between 1996 and 1997.

None of the procedures had higher death rates at teaching hospitals. The death rates for the three procedures were as follows:

>> Pancreatic resections: The death rate was 4% at teaching hospitals versus. 9% at non-teaching hospitals

>> Hepatic resection: 5% versus 8%

>> Esophageal resection: 8% versus 10%

"Teaching hospitals have lower operative mortality rates for pancreatic, hepatic, and esophageal resections compared with non-teaching hospitals," they write, "but these differences can be attributed to higher volume at teaching hospitals. Further studies should concentrate on the structure and process variables, other than volume, that contribute to variation in outcomes between hospitals."

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