High-volume hospitals

There are too few hi-volume hospitals: in 2016 less than 25% of hospitals that performed pancreatic, lung, rectal, and esophageal cancer surgery met even modest volume standards.

Decreased mortality for elective abdominal aortic aneurysm repair, carotid endarterectomy, lower extremity arterial bypass surgery, coronary artery bypass surgery, coronary angioplasty, heart transplantation, pediatric surgery and the treatment of AIDS.

For esophagectomy or pancreatic resection the rates of aspiration pneumonia, renal insufficiency and sepsis complications are lower than in low-volume hospitals.

Benchmarks for esophagectomy is 19 per year and for pancreatectomy 16 per year.

Fewer urinary complications seen in patients with radical prostatectomy than in lower-volume hospitals.

In neonatal intensive care units in community hospitals mortality among very low birth weight infant is less in those facilities with high level of care and high volume of such patients.

In general, Medicaid, black, Hispanic and uninsured less likely to go to such hospitals and more likely to go to low volume hospitals compared to insured, whites and Medicare recipients.

30 day mortality rates for transcatheter aortic valve replacement are higher and more variable in hospitals with low procedural volume than in hospitals with a high procedural volume.

There is significant variation in surgical quality among high-volume hospitals, and some low volume hospitals have good outcomes, making it uncertain uncertain about what drives better outcomes at high-volume hospitals.

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