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Referral to high-volume hospitals for operations fails to improve outcomes statewide
Date:3/10/2011

urysm (AAA) repair (16.3% vs. 17.6%, p = 0.13). In general, rates of adverse events were lower at hospitals meeting an EBHR volume metric. However, across Washington State and at non-EBHR centers, rates of mortality, readmission, and complications generally did not improve in the seven years following the introduction of the EBHR initiative.

The implications of Leapfrog's EBHR program for the health care system include: limiting patient flow and critically important revenue at smaller hospitals; decreasing surgeon competence and availability for emergency care at lower volume hospitals; providing fewer opportunities for surgical residency training at lower volume centers; and biasing patients toward higher volume centers for procedures not related to the EBHR initiative.

The consequences of referring patients to high-volume surgical centers are still being understood, but it appears as though doing so may not result in improved outcomes in the population as a whole.


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