State of evidence on the relationship between high-volume hospitals and outcomes in surgery: A systematic review of systematic reviews

摘要

In particular in surgical disciplines, many studies have been published on the volume—outcomes relationship since Luft and colleagues12 explained their theory of it. A lot of empirical work has shown differences in patient outcomes between high-volume hospitals (HVH) and low-volume hospitals (LVH) in favor of HVH.3"5 Mortality and survival have been explored the most in this debate. According to theory, superior outcomes in HVH can be explained by their structural characteristics (eg, teaching status or ownership) and a higher degree of experience.1 From this, it follows that the volume-outcomes relationship is likely to be most eminent in high-risk, low-volume procedures, such as pancreatec-tomy or esophagectomy.