Resident versus no resident: A single institutional study on operative complications, mortality, and cost

Christine S. Hwang, Christina R. Pagano, Keith A. Wichterman, Gary Dunnington, Edward J. Alfrey

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Background: Previous studies have demonstrated an increase in surgical morbidity, mortality, duration of stay, and costs in teaching hospitals. These studies are confounded by many variables. Controlling for these variables, we studied the effect of surgical residents on these outcomes during rotations with non-academic-based teaching faculty at a teaching hospital. Methods: Patients received care at a single teaching hospital from a group of 8 surgeons. Four surgeons did not have resident coverage (group 1) and the other 4 had coverage (group 2). Continuous severity adjusted complications, mortality, length of stay, cost, and hospital margin data were collected and compared. Results: Five common procedures were examined: bowel resection, laparoscopic cholecystectomy, hernia, mastectomy, and appendectomy. Comparing all procedures together, there were no differences in complications between the groups, although there was greater mortality, a greater duration of stay, and higher costs in group 2. When comparing the 5 most common procedures individually, there was no difference in complications or mortality, although a greater length of stay and higher costs in group 2. Conclusions: Comparing the most common procedures performed individually, patients cared for by surgeons with surgical residents at a teaching hospital have an increase in duration of stay and cost, although no difference in complications or mortality compared to surgeons without residents.

Original languageEnglish (US)
Pages (from-to)339-344
Number of pages6
JournalSurgery
Volume144
Issue number2
DOIs
StatePublished - Aug 2008
Externally publishedYes

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Teaching Hospitals
Costs and Cost Analysis
Mortality
Length of Stay
Appendectomy
Hospital Costs
Laparoscopic Cholecystectomy
Mastectomy
Hernia
Patient Care
Teaching
Morbidity
Surgeons

ASJC Scopus subject areas

  • Surgery

Cite this

Resident versus no resident : A single institutional study on operative complications, mortality, and cost. / Hwang, Christine S.; Pagano, Christina R.; Wichterman, Keith A.; Dunnington, Gary; Alfrey, Edward J.

In: Surgery, Vol. 144, No. 2, 08.2008, p. 339-344.

Research output: Contribution to journalArticle

Hwang, Christine S. ; Pagano, Christina R. ; Wichterman, Keith A. ; Dunnington, Gary ; Alfrey, Edward J. / Resident versus no resident : A single institutional study on operative complications, mortality, and cost. In: Surgery. 2008 ; Vol. 144, No. 2. pp. 339-344.
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