Should Operations Be Regionalized?

摘要: This study examines mortality rates for 12 surgical procedures of varying complexity in 1498 hospitals to determine whether there is a relation between hospital's volume and its mortality. The open-heart surgery, vascular transurethral resection the prostate, coronary bypass decreased with increasing number operations. Hospitals which 200 or more these operations were done annually had death rates, adjusted case mix, 25 41 per cent lower than volumes. For other procedures, curve flattened at example, doing 50 100 total hip replacements attained rate this procedure almost as low that more. Some such cholecystectomy, showed no results may reflect effect experience on mortality, referrals institutions better outcomes, well factors, patient selection. Regardless explanation, data support value regionalization certain