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Hospital volume inconsistent predictor of quality care
Date:5/4/2009

e effect on mortality. The authors say the lack of consistent results from individual studies calls into question the validity of case volume as a proxy for care quality, and leads the authors to conclude that more direct quality measures and the validity of their use to inform policy should also be explored. "On the basis of mortality outcomes alone, it appears prudent to support volume-based referral and high-volume centers," write the authors. But they point out outcomes may also depend on an individual surgeon's case volume. A large center where many surgeons each do a low volume of procedures, for example, may have higher mortality rates than a small practice where a one or two surgeons limit their practice to a particular operation. They conclude: "[T]here are also clearly some low-volume providers who get good results, and therefore referral to relatively low-volume providers should be supported if good outcomes can be demonstrated by process measures or by risk-adjusted outcomes, especially if there are compelling personal or medical reasons for the patient to be treated close to home."


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Contact: David Sampson
david.sampson@cancer.org
American Cancer Society
Source:Eurekalert

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