Physiological Complexity of Pediatric Surgery Between Types of Hospitals

Study Overview
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Brief Summary
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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.

Official Title
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Incidences of Non-physiologically Complex Surgical Procedures Performed in Children and Their Similarity of Distribution Between Pediatric Specialist Hospitals and Other Hospitals Performing Pediatric Surgery

Conditions
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Health Services

Intervention / Treatment
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* Procedure: Pediatric surgical procedures


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 28 Days
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Pediatric specialist hospitals<br>Free-standing hospitals providing tertiary pediatric referral services and performing pediatric surgical procedures | Procedure: Pediatric surgical procedures<br>* Eligible surgical procedures were identified using Canadian Classification of Health Interventions (CCI) therapeutic intervention codes.<br>|
| Non-pediatric specialist hospitals<br>Other hospitals performing pediatric surgical procedures | Procedure: Pediatric surgical procedures<br>* Eligible surgical procedures were identified using Canadian Classification of Health Interventions (CCI) therapeutic intervention codes.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of non-physiologically complex surgery | The proportion of non-physiologically complex pediatric surgical procedures | April 1, 2007 to March 31, 2015 | 

Secondary Outcome Measures

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

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Similarity, Diversity