Hospital Volume and Operative Mortality in the Modern Era

Volume-outcomes relationships for operative mortality were first identified more than a decade ago.  This study updated the data using Medicare claims for more than 3 million patients.  The inverse relationship between volume and outcomes was confirmed for all 8 procedures studied.  The inverse ratio actually increased for 5 of 8 procedures despite overall improvements in outcomes.  For esophagectomy mortality the OR for very low compared to very high volumes was 2.25 in 2000-2001 and 3.68 in 2008-2009.