Background
Type of intervention (including) | 2004 | 2006 | 2008 | 2010 | 2012 |
---|---|---|---|---|---|
Complex esophageal interventions (partial/total esophagectomy, implant of magnetic antireflux device, gastrectomy with subtotal esophageal resection) | 5 | 10 | 10 | 10 | 10 |
Complex pancreatic interventions (partial/total pancreatectomy, internal drainage of pancreas) | 5 | 10 | 10 | 10 | 10 |
Kidney transplantation (re-transplantation) | 20 | 25 | 25 | 25 | 25 |
Liver transplantation (re-transplantation, hepatectomy, partial hepatectomy from living donor) | 10 | 20 | 20 | 20 | 20 |
Stem cell transplantation (transplantation of hematopoietic stem cells from bone marrow, transfusion of peripheral hematopoietic stem cells) | 12 | 25 | 25 | 25 | 25 |
Total knee replacement | - | 50 | 50 | 50 | 50 |
Methods
Ethics statement
Results
Number of hospitals per minimum volume and compliance with minimum volume standards over time
2006 | 2008 | 2010 | p | |
---|---|---|---|---|
Hospitals with no. of cases ≥ 1 | 437 | 444 | 461 | |
Change to 2006 | - | +1,6 % | +5,5 % | |
Annual no. of cases | 8258 | 8843 | 9180 | |
Change to 2006 | - | +7,1 % | +11,2 % | |
Min. – max. | 1–384 | 1–395 | 1–427 | |
Median | 11,00 | 13,00 | 13,00 | |
Mean (SD) | 18,90 (31,6) | 19,92 (29,3) | 19,91 (29,6) | |
Hospitals complying MVS*: 10 per year | 279 (63,8 %) | 311 (70,0 %) | 328 (71,1 %) | |
No. of cases in hospitals complying MVS | 7534 (91,2 %) | 8236 (93,1 %) | 8576 (93,4 %) | |
Hospitals not complying MVS | 158 (36,2 %) | 133 (30,0 %) | 133 (28,9 %) | |
No. of cases in hospitals not complying MVS | 724 (8,8 %) | 607 (6,9 %) | 604 (6,6 %) | |
Quintile 1 hospitals | 87 | 88 | 92 | |
No. of cases | 4794 | 4938 | 5087 | 0,735** |
Percentage of annual cases | 58,0 % | 55,8 % | 55,4 % | |
Min. – max. | 25–384 | 25–395 | 27–427 | |
Median | 38,00 | 40,00 | 39,00 | |
Mean (SD) | 55,10 (57,0) | 56,11 (50,6) | 55,29 (51,8) | |
Quintile 2 hospitals | 87 | 89 | 92 | |
No. of cases | 1550 | 1682 | 1770 | 0,002** |
Percentage of annual cases | 18,8 % | 19,0 % | 19,3 % | |
Min. – max. | 14–25 | 15–25 | 15–26 | |
Median | 17,00 | 18,00 | 18,00 | |
Mean (SD) | 17,82 (3,4) | 18,90 (2,5) | 19,24 (3,2) | |
Quintile 3 hospitals | 87 | 89 | 92 | |
No. of cases | 1010 | 1152 | 1182 | <0,001** |
Percentage of annual cases | 12,2 % | 13,0 % | 12,9 % | |
Min. – max. | 10–14 | 11–15 | 11–15 | |
Median | 12,00 | 13,00 | 13,00 | |
Mean (SD) | 11,61 (1,1) | 12,94 (1,3) | 12,85 (1,3) | |
Quintile 4 hospitals | 88 | 89 | 92 | |
No. of cases | 673 | 802 | 860 | <0,001** |
Percentage of annual cases | 8,1 % | 9,1 % | 9,4 % | |
Min. – max. | 5–10 | 6–11 | 7–11 | |
Median | 8,00 | 10,00 | 10,00 | |
Mean (SD) | 7,65 (1,6) | 9,01 (1,5) | 9,35 (1,3) | |
Quintile 5 hospitals | 88 | 89 | 93 | |
No. of cases | 231 | 269 | 281 | 0,295** |
Percentage of annual cases | 2,8 % | 3,0 % | 3,1 % | 0,999# |
Min. – max. | 1–5 | 1–6 | 1–6 | |
Median | 3,00 | 3,00 | 3,00 | |
Mean (SD) | 2,63 (1,4) | 3,02 (1,8) | 3,02 (1,7) |
Caseload change over time
2006 | 2008 | 2010 | p | |
---|---|---|---|---|
Hospitals with no. of cases ≥ 1 | 271 | 275 | 283 | |
Change to 2006 | - | +1,5 % | +4,4 % | |
Annual no. of cases | 3315 | 3422 | 3576 | |
Change to 2006 | - | +3,2 % | +7,9 % | |
Min. – max. | 1–150 | 1–124 | 1–112 | |
Median | 10,00 | 10,00 | 10,00 | |
Mean (SD) | 12,23 (13,8) | 12,44 (14,1) | 12,64 (14,2) | |
Hospitals complying MVS*: 10 per year | 154 (56,8 %) | 148 (53,8 %) | 160 (56,5 %) | |
No. of cases in hospitals complying MVS | 2809 (84,7 %) | 2875 (84,0 %) | 3066 (85,7 %) | |
Hospitals not complying MVS | 117 (43,2 %) | 127 (46,2 %) | 123 (43,5 %) | |
No. of cases in hospitals not complying MVS | 506 (15,3 %) | 547 (16,0 %) | 510 (14,3 %) | |
Quintile 1 hospitals | 54 | 55 | 57 | |
No. of cases | 1636 | 1800 | 1857 | 0,302** |
Percentage of annual cases | 49,4 % | 52,6 % | 51,9 % | |
Min. – max. | 16–150 | 17–124 | 17–112 | |
Median | 22,50 | 24,00 | 23,00 | |
Mean (SD) | 30,30 (22,0) | 32,73 (20,3) | 32,58 (20,7) | |
Quintile 2 hospitals | 54 | 55 | 56 | |
No. of cases | 696 | 687 | 729 | 0,165** |
Percentage of annual cases | 21,0 % | 20,1 % | 20,4 % | |
Min. – max. | 11–16 | 11–16 | 11–17 | |
Median | 12,50 | 12,00 | 12,00 | |
Mean (SD) | 12,89 (1,5) | 12,49 (1,6) | 13,02 (1,8) | |
Quintile 3 hospitals | 55 | 55 | 57 | |
No. of cases | 557 | 537 | 569 | 0,040** |
Percentage of annual cases | 16,8 % | 15,7 % | 15,9 % | |
Min. – max. | 8–11 | 8–11 | 8–11 | |
Median | 10,00 | 10,00 | 10,00 | |
Mean (SD) | 10,13 (0,7) | 9,76 (0,8) | 9,98 (0,6) | |
Quintile 4 hospitals | 54 | 55 | 56 | |
No. of cases | 321 | 297 | 325 | 0,092** |
Percentage of annual cases | 9,7 % | 8,7 % | 9,1 % | |
Min. – max. | 4–8 | 4–8 | 3–8 | |
Median | 6,00 | 5,00 | 6,00 | |
Mean (SD) | 5,94 (1,3) | 5,40 (1,3) | 5,80 (1,4) | |
Quintile 5 hospitals | 54 | 55 | 57 | |
No. of cases | 105 | 101 | 96 | 0,405** |
Percentage of annual cases | 3,2 % | 3,0 % | 2,7 % | 0,999# |
Min. – max. | 1–4 | 1–4 | 1–3 | |
Median | 2,00 | 2,00 | 2,00 | |
Mean (SD) | 1,94 (0,9) | 1,84 (1,0) | 1,68 (0,8) |
2006 | 2008 | 2010 | p | |
---|---|---|---|---|
Hospitals with no. of cases ≥ 1 | 855 | 905 | 949 | |
Change to 2006 | - | +5,8 % | +11,0 | |
Annual no. of cases | 114852 | 139287 | 143593 | |
Change to 2006 | - | +21,3 % | +25 % | |
Min. – max. | 1–979 | 1–1329 | 1–1367 | |
Median | 93,00 | 109,00 | 107,00 | |
Mean (SD) | 134,33 (126,7) | 153,91 (144,1) | 151,31 (140,4) | |
Hospitals complying MVS*: 50 per year | 745 (87,1 %) | 834 (92,2 %) | 870 (91,7 %) | |
No. of cases in hospitals complying MVS | 112305 (97,8 %) | 137586 (98,8 %) | 141597 (98,6 %) | |
Hospitals not complying MVS | 110 (12,9 %) | 71 (7,8 %) | 79 (8,3 %) | |
No. of cases in hospitals not complying MVS | 2547 (2,2 %) | 1701 (1,2 %) | 1996 (1,4 %) | |
Quintile 1 hospitals | 171 | 181 | 190 | |
No. of cases | 56617 | 67795 | 69609 | 0,001** |
Percentage of annual cases | 49,3 % | 48,7 % | 48,5 % | |
Min. – max. | 191–979 | 215–1329 | 219–1367 | |
Median | 276,00 | 318,00 | 309,50 | |
Mean (SD) | 331,09 (153,4) | 374,56 (181,9) | 366,36 (177,0) | |
Quintile 2 hospitals | 171 | 181 | 190 | |
No. of cases | 25650 | 30686 | 31322 | <0,001** |
Percentage of annual cases | 22,3 % | 22,0 % | 21,8 % | |
Min. – max. | 117–190 | 133–215 | 130–218 | |
Median | 147,00 | 168,00 | 163,50 | |
Mean (SD) | 150,00 (21,3) | 169,54 (24,3) | 164,85 (23,7) | |
Quintile 3 hospitals | 171 | 181 | 189 | |
No. of cases | 16051 | 19870 | 20635 | <0,001** |
Percentage of annual cases | 14,0 % | 14,3 % | 14,4 % | |
Min. – max. | 75–116 | 89–153 | 91–130 | |
Median | 93,00 | 109,00 | 107,00 | |
Mean (SD) | 93,87 (11,9) | 109,78 11,5) | 109,18 (11,7) | |
Quintile 4 hospitals | 171 | 181 | 190 | |
No. of cases | 10857 | 13302 | 14042 | <0,001** |
Percentage of annual cases | 9,5 % | 9,6 % | 9,8 % | |
Min. – max. | 53–75 | 60–89 | 59–91 | |
Median | 63,00 | 74,00 | 73,00 | |
Mean (SD) | 63,49 (6,7) | 73,49 (8,1) | 73,91 (9,2) | |
Quintile 5 hospitals | 171 | 181 | 190 | |
No. of cases | 5677 | 7634 | 7985 | <0,001** |
Percentage of annual cases | 4,9 % | 5,5 % | 5,6 % | 0,999# |
Min. – max. | 1–53 | 1–60 | 1–59 | |
Median | 40,00 | 51,00 | 51,00 | |
Mean (SD) | 33,20 (18,1) | 42,18 (18,0) | 42,03 (17,6) |
2006 | 2008 | 2010 | p | |
---|---|---|---|---|
Hospitals with no. of cases ≥ 1 | 40 | 40 | 37 | |
Change to 2006 | - | 0,0 % | −7,5 % | |
Annual no. of cases | 2784 | 2784 | 2856 | |
Change to 2006 | - | 0,0 % | +2,6 % | |
Min. – max. | 4–251 | 9–255 | 12–264 | |
Median | 57,50 | 60,50 | 69,00 | |
Mean (SD) | 69,60 (48,4) | 69,60 (48,7) | 77,19 (51,7) | |
Hospitals complying MVS*: 25 per year | 38 (95 %) | 36 (90,0 %) | 35 (94,6 %) | |
No. of cases in hospitals complying MVS | 2769 (99,5 %) | 2721 (97,7 %) | 2824 (98,9 %) | |
Hospitals not complying MVS | 2 (5,0 %) | 4 (10,0 %) | 2 (5,4 %) | |
No. of cases in hospitals not complying MVS | 15 (0,5 %) | 63 (2,3 %) | 32 (1,1 %) | |
Tercile 1 hospitals | 13 | 13 | 12 | |
No. of cases | 1581 | 1597 | 1598 | 0,438** |
Percentage of annual cases | 56,8 % | 57,3 % | 56,0 % | |
Min. – max. | 85–251 | 86–255 | 96–264 | |
Median | 105,00 | 107,00 | 117,00 | |
Mean (SD) | 121,62 (48,3) | 122,85 (47,5) | 133,17 (51,0) | |
Tercile 2 hospitals | 14 | 14 | 13 | |
No. of cases | 837 | 830 | 883 | 0,288** |
Percentage of annual cases | 30,1 % | 29,8 % | 30,9 % | |
Min. – max. | 39–84 | 39–84 | 40–94 | |
Median | 57,50 | 60,50 | 69,00 | |
Mean (SD) | 59,79 (16,1) | 59,29 (15,1) | 67,92 (15,6) | |
Tercile 3 hospitals | 13 | 13 | 12 | |
No. of cases | 366 | 357 | 375 | 0,433** |
Percentage of annual cases | 13,1 % | 12,8 % | 13,1 % | 0,999# |
Min. – max. | 4–38 | 9–38 | 12–39 | |
Median | 32,00 | 30,00 | 33,50 | |
Mean (SD) | 28,15 (10,4) | 27,46 (9,0) | 31,25 (8,0) |
2006 | 2008 | 2010 | ||
---|---|---|---|---|
Hospitals with no. of cases ≥ 1 | 81 | 73 | 84 | |
Change to 2006 | - | −9,9 % | +2,5 % | |
Annual no. of cases | 6181 | 5542 | 6320 | |
Change to 2006 | - | −10,3 % | +2,2 % | |
Min. – max. | 1–349 | 1–306 | 1–320 | |
Median | 40,00 | 40,00 | 38,50 | |
Mean (SD) | 76,31 (78,9) | 75,92 (74,9) | 75,24 (77,5) | |
Hospitals complying MVS*: 25 per year | 63 (77,8 %) | 55 (75,3 %) | 62 (73,8 %) | |
No. of cases in hospitals complying MVS | 5927 (95,9 %) | 5290 (95,5 %) | 6030 (95,4 %) | |
Hospitals not complying MVS | 18 (22,2 %) | 18 (24,7 %) | 21 (26,2 %) | |
No. of cases in hospitals not complying MVS | 254 (4,1 %) | 252 (4,5 %) | 290 (5,6 %) | |
Tercile 1 hospitals | 27 | 24 | 28 | |
No. of cases | 4497 | 3940 | 4694 | 0,904** |
Percentage of annual cases | 72,8 % | 71,1 % | 74,3 % | |
Min. – max. | 80–349 | 83–306 | 82–320 | |
Median | 143,00 | 153,00 | 158,00 | |
Mean (SD) | 166,56 (76,1) | 164,17 (67,1) | 167,64 (167,6) | |
Tercile 2 hospitals | 27 | 24 | 28 | |
No. of cases | 1202 | 1170 | 1184 | 0,381** |
Percentage of annual cases | 19,4 % | 21,1 % | 18,7 % | |
Min. – max. | 27–79 | 27–82 | 26–82 | |
Median | 40,00 | 40,50 | 38,50 | |
Mean (SD) | 44,52 (16,0) | 48,75 (19,3) | 42,29 (16,1) | |
Tercile 3 hospitals | 27 | 25 | 28 | |
No. of cases | 482 | 432 | 442 | 0,547** |
Percentage of annual cases | 7,8 % | 7,8 % | 7,0 % | 0,990# |
Min. – max. | 1–26 | 1–26 | 1–26 | |
Median | 19,00 | 19,00 | 16,00 | |
Mean (SD) | 17,85 (7,6) | 17,28 (8,5) | 15,79 (7,7) |
2006 | 2008 | 2010 | ||
---|---|---|---|---|
Hospitals with no. of cases ≥ 1 | 23 | 23 | 23 | |
Change to 2006 | - | 0,0 % | 0,0 % | |
Annual no. of cases | 1381 | 1386 | 1464 | |
Change to 2006 | - | +0,4 % | +6,0 % | |
Min. – max. | 16–143 | 11–146 | 17–160 | |
Median | 51,00 | 47,00 | 60,00 | |
Mean (SD) | 60,04 (36,7) | 60,26 (37,9) | 63,65 (35,7) | |
Hospitals complying MVS*: 20 per year | 22 (95,7 %) | 20 (87,0 %) | 22 (95,7 %) | |
No. of cases in hospitals complying MVS | 1365 (98,8 %) | 1349 (97,3 %) | 1447 (98,8 %) | |
Hospitals not complying MVS | 1 (4,3 %) | 3 (13,0 %) | 1 (4,3 %) | |
No. of cases in hospitals not complying MVS | 16 (1,2 %) | 37 (2,7 %) | 17 (1,2 %) | |
Tercile 1 hospitals | 7 | 7 | 7 | |
No. of cases | 739 | 748 | 749 | 0,989** |
Percentage of annual cases | 53,5 % | 54,0 % | 51,2 % | |
Min. – max. | 65–143 | 80–146 | 90–160 | |
Median | 103,00 | 102,00 | 97,00 | |
Mean (SD) | 105,57 (29,6) | 106,86 (24,4) | 107,00 (24,4) | |
Tercile 2 hospitals | 8 | 8 | 8 | |
No. of cases | 426 | 444 | 483 | 0,428** |
Percentage of annual cases | 30,8 % | 32,0 % | 33,0 % | |
Min. – max. | 46–60 | 42–70 | 43–81 | |
Median | 53,50 | 55,50 | 60,00 | |
Mean (SD) | 53,25 (5,4) | 55,50 (13,3) | 60,38 (12,2) | |
Tercile 3 hospitals | 8 | 8 | 8 | |
No. of cases | 216 | 194 | 232 | 0,578** |
Percentage of annual cases | 15,6 % | 14,0 % | 15,8 % | 0,990# |
Min. – max. | 16–41 | 11–41 | 17–43 | |
Median | 24,50 | 20,50 | 28,50 | |
Mean (SD) | 27,00 (8,5) | 24,25 (12,5) | 29,00 (9,4) |