TY - JOUR
T1 - Bariatric Outcomes are Significantly Improved in Hospitals with Fellowship Council-Accredited Bariatric Fellowships
AU - Kim, Pamela S.
AU - Telem, Dana A.
AU - Altieri, Maria S.
AU - Talamini, Mark
AU - Yang, Jie
AU - Zhang, Qiao
AU - Pryor, Aurora D.
N1 - Funding Information:
Similarly, our study also supports the safety of fellowship trainees with the additional support of improved outcomes in institutions with a training program. This can be identified to stem from a variety of factors. As Fellowship Council accreditation of a program requires, among other things, high volume of cases and experienced attending surgeons, there is a recognizable relationship with the positive outcomes associated with high-volume centers. Along with this, there is a multidisciplinary approach taken with bariatric patients, especially within a teaching institution. The fellow is only one part of the team. Resident physicians, nursing staff, operative personnel, physician extenders, and all the other individuals who make up an institution with a fellowship program also play a role. This interaction may contribute to earlier detection of issues and their appropriate management, ultimately leading to improved outcomes. ,
Publisher Copyright:
© 2015, The Society for Surgery of the Alimentary Tract.
PY - 2015/4
Y1 - 2015/4
N2 - Background: With the increasing demand of bariatric surgery, there is a need to train more surgeons, while identifying institutional factors associated with improved outcomes. Little is known regarding the impact of a fellowship training program on institutional outcomes. This study examines the effect of bariatric fellowship program status on perioperative outcomes within New York state. Methods: Using the New York statewide planning and research cooperative system, 47,342 adult patients in 91 hospitals were identified who underwent a laparoscopic bariatric surgery over a 6-year period. Hospitals with fellowships were identified from the Fellowship Council. Statistical comparison between patient demographics, payer source, comorbidities, bariatric procedure performed, and perioperative outcomes in hospitals with and without fellowship were performed. Results: On univariate analysis, fellowship accreditation status was found to be associated with increased rates of cardiac complications and shock and decreased rates of pneumonia. Overall complication rate was not significantly different in fellowship versus non-fellowship institutions. However, when controlled for patient demographic, payer source, comorbidity, and operative procedure, there were significantly improved bariatric outcomes among institutions with fellowship programs. Conclusions: The presence of a fellowship program correlates with improved hospital outcomes, mitigating potential concerns about possible negative effects of trainees on hospitals and patients.
AB - Background: With the increasing demand of bariatric surgery, there is a need to train more surgeons, while identifying institutional factors associated with improved outcomes. Little is known regarding the impact of a fellowship training program on institutional outcomes. This study examines the effect of bariatric fellowship program status on perioperative outcomes within New York state. Methods: Using the New York statewide planning and research cooperative system, 47,342 adult patients in 91 hospitals were identified who underwent a laparoscopic bariatric surgery over a 6-year period. Hospitals with fellowships were identified from the Fellowship Council. Statistical comparison between patient demographics, payer source, comorbidities, bariatric procedure performed, and perioperative outcomes in hospitals with and without fellowship were performed. Results: On univariate analysis, fellowship accreditation status was found to be associated with increased rates of cardiac complications and shock and decreased rates of pneumonia. Overall complication rate was not significantly different in fellowship versus non-fellowship institutions. However, when controlled for patient demographic, payer source, comorbidity, and operative procedure, there were significantly improved bariatric outcomes among institutions with fellowship programs. Conclusions: The presence of a fellowship program correlates with improved hospital outcomes, mitigating potential concerns about possible negative effects of trainees on hospitals and patients.
KW - Bariatric surgery
KW - Fellowship
KW - Outcomes
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U2 - 10.1007/s11605-015-2758-7
DO - 10.1007/s11605-015-2758-7
M3 - Article
C2 - 25666098
AN - SCOPUS:84925510168
SN - 1091-255X
VL - 19
SP - 594
EP - 597
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 4
ER -