Clinical trial NCT03144544: Physiological Complexity of Pediatric Surgery Between Types of Hospitals
Official title: 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
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Health Services
Keywords: Similarity
Diversity
Lead sponsor: The Hospital for Sick Children
Sponsor class: OTHER
First posted: 2017-05-09
Enrollment: 830830
Sex: ALL
Minimum age (years): 28
Maximum age (years): 17
Standard ages: CHILD
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Pediatric surgical procedures

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.


Eligibility criteria: 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

Primary outcomes:
measure: Incidence of non-physiologically complex surgery
timeFrame: April 1, 2007 to March 31, 2015
Secondary outcomes:
measure: Similarity
timeFrame: April 1, 2007 to March 31, 2015
measure: Diversity
timeFrame: April 1, 2007 to March 31, 2015
Other outcomes:
Locations:
city: Toronto
country: Canada
facility: The Hospital for Sick Children
state: Ontario
Study officials:
affiliation: The Hospital for Sick Children
name: James D O'Leary, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: O'Leary JD, Dexter F, Faraoni D, Crawford MW. Incidence of non-physiologically complex surgical procedures performed in children: an Ontario population-based study of health administrative data. Can J Anaesth. 2018 Jan;65(1):23-33. doi: 10.1007/s12630-017-0993-y. Epub 2017 Nov 17.