Studies About Patient Load's Effects on Quality of Healthcare

How does surgeon volume affect the quality of healthcare?

Image Credit: By Jrahma [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], from Wikimedia Commons

All systems work best within their capacity and strengths. Hospitals and healthcare providers are no exception to this. Both very high and the very low load of patients can compromise the quality of care. Every provider has his/her areas of strengths and weaknesses.

A lot of scientific inquiry has been made into finding the right place for a procedure and the right number of patients to which a doctor can provide quality care. Many professional organizations and countries impose caseload parameters for ensuring optimal quality of care.

How a low load of patients can affect the quality of care?

When the disease management is highly complex and requires high expertise and regular exposure to the disease and its various forms, the lack of practice or exposure can limit the ability to handle the surprise complications that are a part and parcel of the practice.

When did a low patient load result in poor quality?

Research has shown benefits of a high caseload in following conditions and procedures: AIDS, abdominal aortic aneurysm (ruptured and unruptured), coronary angioplasty, myocardial infarction, knee arthroplasty, coronary artery bypass, cancer surgery (breast, lung, colon, colon rectum, kidney, liver, stomach, bladder, esophagus, pancreas, prostate); cholecystectomy, brain aneurysm, carotid endarterectomy, hip fracture, lower extremity bypass surgery, subarachnoid hemorrhage, neonatal intensive care, pediatric heart surgery.

Whose volumes affect quality higher, the surgeons' or hospitals'?

While both are important and can affect the quality of care, the surgeon's volume is more important when the length of stay after the procedure is short. On the other hand, hospital volume is more important when lengths of stay after the procedure are long. For technically less complex procedures, the hospital has a greater influence than the performing surgeon on the quality of care.

How a high load of patients can affect the quality of care?

Due to high load, the time available for disease management may be insufficient and the disease-specific expertise may not be available with the provider.

When did a high patient load result in poor quality?

In the management of chronic diseases like diabetes, primary care physicians with busier patient practices delivered lower-quality diabetes care. In the management of respiratory infections, higher volume physicians had lower quality scores.

About the author: Dr. Naval Asija is a licensed MBBS Physician from India. MBBS is the equivalent of the MD degree offered by international medical schools. He is based in Delhi, India, and works as a medical writer, editor, and consultant. He supports medical researches as an author's editor, medical communication companies involved in medico-marketing activities, and medical technology companies in improving their products. He can be contacted via his LinkedIn Profile: https://www.linkedin.com/in/navalasija/

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