Disparities in the Utilization of High-Volume Hospitals for Complex Surgery

Authors:
  • DZDavid S. Zingmond
    David S. Zingmond
  • MMMarcia L. McGory
    Marcia L. McGory
  • NSNelson F. SooHoo
    Nelson F. SooHoo
  • SESusan L. Ettner
    Susan L. Ettner
  • RBRobert H. Brook
    Robert H. Brook
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Abstract
Efforts to improve the quality of surgical care in the United States have led many organizations to advocate the use of high-volume hospitals for certain procedures. For example, the Leapfrog Group,1 a consortium of more than 170 private and public organizations that insure nearly 35 million individuals, incorporated volume standards for 5 operations (abdominal aortic aneurysm [AAA] repair, coronary artery bypass grafting [CABG], esophagectomy, coronary angioplasty, and pancreatic resection) into their hospital referral criteria. These recommendations rely on the use of the number of procedures performed at a hospital, a structural characteristic, as a marker of quality.