Health Affairs, 22, no. 2 (2003): 167-177 doi: 10.1377/hlthaff.22.2.167 © 2003 by Project HOPE	New Online   New Issue: China & India   Obesity In China   Pay Cuts For Medicare Docs   Access To Care Woes

This Article Full Text (HTML) Reprint (PDF) Submit a response to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Archive Download to Citation Manager Reprints & Permissions Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (23) Citing Articles via Google Scholar Google Scholar Articles by Elixhauser, A. Articles by Fraser, I. Search for Related Content PubMed PubMed Citation Articles by Elixhauser, A. Articles by Fraser, I. Related Collections Hospitals Quality Of Care Workforce Issues

Research Challenge

Volume Thresholds And Hospital Characteristics In The United States

Procedure volume has been used as a proxy for quality and recommended as a basis for hospital referrals. We studied the volume, mortality, and associated hospital and staffing characteristics of ten complex procedures in U.S. hospitals using the 2000 HCUP Nationwide Inpatient Sample. Although the majority of patients had their procedures performed in high-volume hospitals, for seven procedures, more than three-fourths of hospitals would be considered low-volume. Unadjusted mortality rates were significantly higher at low-volume hospitals for five procedures. Low-volume hospitals also tended to have lower mean numbers of residents and RNs. However, for two procedures, low-volume hospitals had RN and resident staffing equal to or higher than those of high-volume hospitals, and the unadjusted mortality rates were no different.

                      What's this?

This article has been cited by other articles:

				L. R. Hearld, J. A. Alexander, I. Fraser, and H. J. Jiang Review: How Do Hospital Organizational Structure and Processes Affect Quality of Care?: A Critical Review of Research Methods Med Care Res Rev, June 1, 2008; 65(3): 259 - 299. [Abstract] [PDF]

				P. E. Rivard, S. L. Luther, C. L. Christiansen, Shibei Zhao, S. Loveland, A. Elixhauser, P. S. Romano, and A. K. Rosen Using Patient Safety Indicators to Estimate the Impact of Potential Adverse Events on Outcomes Med Care Res Rev, February 1, 2008; 65(1): 67 - 87. [Abstract] [PDF]

				J. G. Berry, T. A. Lieu, P. W. Forbes, and D. A. Goldmann Hospital Volumes for Common Pediatric Specialty Operations Arch Pediatr Adolesc Med, January 1, 2007; 161(1): 38 - 43. [Abstract] [Full Text] [PDF]

				C. Laine and H. C. Sox Does Practice Really Make Perfect? Ann Intern Med, October 21, 2003; 139(8): 696 - 698. [Full Text] [PDF]