Low Volumes of Surgeries in Military Hospitals May Put Patients at Higher Risk of Military Surgical Errors
Research Shows Hospitals with Highest Volumes of Surgeries Achieve the Best Results
According to U.S. News, three decades of research has shown doctors and hospitals with the highest volumes of complex surgical procedures achieve the best results. Most military surgeons, when they are not caring for troops injured in battle, attempt to maintain their skills by working in the Military Health System. The Military Health System offers the same services provided in civilian medicine, serving 9.4 million beneficiaries, including 1.4 million active-duty members, their families, and military retirees. Each day, all military hospitals nationwide have an average of 1,900 inpatients. By contrast, the University of Michigan Medical Center by itself has an average of 900 inpatients daily.
Unlike civilian and VA hospitals (which serve a large number of older patients), military hospitals primarily serve active-duty personnel and military family members with an average age of just under 30. A U.S. News analysis of this data suggests that because surgeons working in the Military Health System have a surgical case shortage and work in remote facilities, some surgeons may attempt to tackle cases that exceed their expertise.
Using data drawn from every military hospital worldwide from 2012 through 2016, U.S. News examined 10 categories of procedures: weight-loss surgery, hip replacement, knee replacement, mitral valve repair, surgery to patch abdominal aortic aneurysms, carotid-artery stenting, and operations to remove cancers of the esophagus, pancreas, rectum, and lung.
U.S. News found that all of these studied procedures are shown to have worse outcomes (such as higher complication and death rates with more military surgical errors) when performed by surgical teams that do small numbers of these surgeries.
A dozen active-duty and retired surgeons who work within the Military Health System were interviewed by U.S. News in conjunction with this study, and they asserted that working within the Military Health System deprives them of the steady stream of patients necessary to maintain their surgical proficiency.
In response to U.S. News mounting evidence that patients fare better with surgeons who perform a higher volume of surgeries Johns Hopkins Health System, the University of Michigan Medical Center and Dartmouth-Hitchcock Medical Center established minimum thresholds for the 10 categories of surgeries analyzed in this report.