Report: Low surgery volumes at military hospitals may harm patients

Surgeons in military hospitals across the U.S. perform complex procedures on active-duty personnel, their family and retirees — but the small volume of operations they perform may be putting patients at risk, according to U.S. News & World Report.

Here are eight report insights.

1. While 30 years of research indicates physicians and hospitals with the highest numbers of certain complex surgical procedures achieve the best results, military surgeons serve a relatively young and healthy population who do not often require surgery. These physicians fail to see a consistent stream of older patients who need surgery to let them refine their surgical skills.

2. "You want to do more. In some cases, you're begging to do more," Scott Steele, MD, chair of colorectal surgery at Cleveland Clinic and former Army surgeon, told U.S. News. Every day, each of the 38 military hospitals across the country have a total of 1,900 inpatients on average, according to Defense Health Agency data. In comparison, Ann Arbor-based University of Michigan Medical Center alone serves approximately 900 inpatients daily.

3. The U.S. News investigation suggests the surgical case shortage, when combined with the remote location of some base hospitals from larger military or civilian medical centers, means numerous surgeons may be taking on cases exceeding their surgical skills.

4. To determine how patient shortages affect patient safety, U.S. News analyzed 10 categories of procedures, including weight-loss surgery, hip replacement, knee replacement and operations to remove cancers, using data from every military hospital across the globe between 2012-16.

5. The procedures in the study are routinely completed in civilian hospitals, and all the procedures have been shown to have worse outcomes, such as higher complication and death rates, when completed by surgical teams with low patient volumes. The findings highlight the military's failure to assure patients who require complex and risky surgeries are referred to facilities with surgical teams that perform the procedures regularly, the report authors noted.

6. In particular, cancer procedures are especially risky for patients, according to experts. "Should surgeons who do less than three rectal cancer [procedures] a year be doing them at all? No," Dr. Steele said, who reviewed the U.S. News data. The data revealed surgeons performed three or fewer rectal cancer procedures at 25 military treatment facilities in 2016 alone, from El Paso, Texas-based William Beaumont Medical Center to Fort Carson, Colo.-based Evans Army Community Hospital.

7. Not one of the 25 facilities, which are now designated as health clinics rather than hospitals, has colon or rectal surgeons on staff, according to information supplied by the Defense Health Agency. Additionally, in 2016, physicians at 13 hospitals did three or fewer esophageal and pancreatic cancer surgeries, which could result in significantly higher death rates in hospitals that rarely perform the operation.

8. "They've known this and ignored it for decades," one surgeon who wished to remain anonymous told U.S. News. "What's the solution? Form a task force? It's the same thing over and over. There's a civilian system in place that will help us prepare for war. The real question is whether there should be a military health system at all."

To read the full U.S. News report, click here

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars