Regional availability of high-volume hospitals for major surgery.
Despite evidence of increased risks, a large number of patients still have surgery in low-volume hospitals. To better understand why, we used Medicare data to study the regional availability of high-volume hospitals. More than half of patients undergoing three procedures in low-volume hospitals lived in regions lacking a high-volume hospital. Some regions simply lacked enough cases to support a high-volume hospital. Other regions had enough cases but too many hospitals performing them. Although consolidation of surgical services may be feasible in some settings, volume-based referral strategies are impractical for many U.S. regions.
Veterans Affairs (VA) Outcomes Group, VA Medical Center, Vermont, USA. Justin.B.Dimick@Dartmouth.edu
Justin B
JB
Dimick
Samuel R G
SR
Finlayson
John D
JD
Birkmeyer
D006297:Health Services Accessibility; D006801:Humans; D006278:Medicare; D012017:Referral and Consultation; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data* / Q000600:supply & distribution*; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*