There are over 36 million medical hospitalizations each year, with the majority being for acute medical illness.

Inverse relationship for mortality in high-volume hospitals is most consistent for surgical procedures for pancreatic resections and esophageal resections.

Patient treated surgically at very high-volume of facilities have improve survival compared with those treated at low- volume facilities.

For all cancers, the risk of death for patients undergoing surgery in very high volume facilities, that is, those treating greater than 900 patients with cancer per year was 88% of that for those who treated at low-volume facilities, those treating less than 275 patients with cancer per year (Stoitzfus, K).

A very small proportion of US hospitals currently meet established volume standards for high-risk operations.

High-volume hospitals have lower operative mortality rates for pancreatic resection, esophagectomy, liver resection and pelvic exenteration.

Larger volume-outcome effects for cancer surgical procedures than for cardiovascular operations.

Not associated with appendiceal rupture rate but is inversely associated with negative appendectomy rates.

In a Medicare review admission to higher volume hospitals associated with a reduction in mortality rates for acute myocardial infarction, congestive heart failure and pneumonia (Ross JS).

Lower hospital treatment volume associated with poor survival in ALL (Maheswaran R).

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.

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