Physiological Complexity of Pediatric Surgery Between Types of Hospitals

Completed

• Conditions: Health Services
• Interventions: Procedure: Pediatric surgical procedures

• Registration Number: NCT03144544
• Lead Sponsor: The Hospital for Sick Children

Brief Summary

When considered from a provincial perspective, quantification of surgical procedures undertaken by different hospitals and healthcare networks is necessary for informing resource allocation and modelling of healthcare services. The investigators hypothesized that i) non-physiologically complex surgical procedures would account for most (\>1/2) of pediatric surgical procedures performed at both pediatric specialist hospitals and the other hospitals performing pediatric surgery, ii) surgical discharges for non-physiologically complex surgical procedures would account for most (\>1/2) in-hospital bed nights among pediatric surgical admissions at both pediatric specialist hospitals and the other hospitals performing pediatric surgery, and iii) the relative distributions of non-physiologically complex surgical procedures, but not physiologically complex procedures, would be at least moderately similar between pediatric specialist hospitals and the other hospitals performing pediatric surgery. To test these 3 hypotheses, the specific objectives of this study were to estimate i) the proportion (primary outcome) of non-physiologically complex pediatric surgical procedures, and ii) the similarity and diversity (secondary outcomes) of non-physiologically and physiologically complex surgical procedures between the pediatric specialist hospitals and the other hospitals performing pediatric surgery in Ontario, Canada.

Detailed Description

Not available

Study Timeline

• Study Start: 2016-05-02
• Primary Completion: 2016-10-27
• Study First Submitted: 2017-05-04
• Study First Submitted QC: 2017-05-08
• Study First Posted: 2017-05-09
• Study Completion: 2017-06-15
• Status Verified: 2018-05
• Last Update Submitted: 2018-05-08
• Last Update Posted: 2018-05-14

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 830830

Inclusion Criteria

• surgical procedures for individuals aged greater than 27 days and less than 18 years

Exclusion Criteria

• newborns (0 to 27 days of age)
• records lacking a patient identifier or age
• non-surgical healthcare interventions

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Pediatric specialist hospitals	Pediatric surgical procedures	Free-standing hospitals providing tertiary pediatric referral services and performing pediatric surgical procedures
Non-pediatric specialist hospitals	Pediatric surgical procedures	Other hospitals performing pediatric surgical procedures

Primary Outcome Measures

Name	Time	Method
Incidence of non-physiologically complex surgery	April 1, 2007 to March 31, 2015	The proportion of non-physiologically complex pediatric surgical procedures

Secondary Outcome Measures

Name	Time	Method
Diversity	April 1, 2007 to March 31, 2015	Effective number of common procedures
Similarity	April 1, 2007 to March 31, 2015	Similarity of different types of pediatric surgical procedures performed between hospitals was assessed using Yue and Clayton's index

Trial Locations

Locations (1)

The Hospital for Sick Children; 🇨🇦 Toronto, Ontario, Canada