Volume–outcome relationship in surgical urology: Myth or reality?

Mayer, Erik K.; Bottle, Alex; Athanasiou, Thanos; Darzi, Ara W.; Vale, Justin A.

doi:10.1016/j.bjmsu.2008.06.004

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Volume 1, Issue 2 , Pages 50-57, September 2008

Volume–outcome relationship in surgical urology: Myth or reality?

Erik K. Mayer
- Department of Urology, Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London W2 1NY, United Kingdom
- Department of Biosurgery & Surgical Technology, Imperial College London, 10th Floor, QEQM Building, St Mary's Hospital Campus, Praed Street, London W2 1NY, United Kingdom
- Corresponding author at: Department of Biosurgery & Surgical Technology, Imperial College London, 10th Floor, QEQM Building, St Mary's Hospital Campus, Praed Street, London W2 1NY, United Kingdom. Tel.: +44 207 886 1947; fax: +44 207 886 1546.
Alex Bottle
- Division of Epidemiology, Public Health and Primary Care, Imperial College London, 12 Smithfield Street, London EC1A 9LA, United Kingdom
Thanos Athanasiou
- Department of Biosurgery & Surgical Technology, Imperial College London, 10th Floor, QEQM Building, St Mary's Hospital Campus, Praed Street, London W2 1NY, United Kingdom
Ara W. Darzi
- Department of Biosurgery & Surgical Technology, Imperial College London, 10th Floor, QEQM Building, St Mary's Hospital Campus, Praed Street, London W2 1NY, United Kingdom
Justin A. Vale
- Department of Urology, Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London W2 1NY, United Kingdom

Received 30 May 2008; received in revised form 12 June 2008; accepted 25 June 2008.

Summary

There has been much interest in the volume–outcome relationship within surgical specialities and the potential impact on service reconfiguration. Recent research has raised questions about the validity of the methodology used in existing volume–outcome studies. This review explores a methodological framework for assessing the volume–outcome relationship and discusses limitations of previous research. In particular reference is made to the existing urological literature in this field. Areas for improvement and the potential for future research are considered.

Keywords: Outcome and process assessment, Urologic surgical procedures