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Rationale for regionalizing high-risk surgery



An operation in 1753, painted by Gaspare Traversi.

In this JAMA piece, Karan R. Chhabra and Justin B. Dimick argue that hospital networks and value-based payment comprise “fertile ground for regionalizing high-risk surgery.”

They describe “the shifts made by hospital networks toward a new type of surgical regionalization to improve surgical outcomes and overall clinical quality.”

“Recently, 3 major medical centers—Dartmouth, Johns Hopkins, and the University of Michigan—declared a ‘volume pledge’ that restricts performance of 10 selected procedures to surgeons and hospitals that meet volume criteria. This followed an announcement by US News & World Report of a new analysis demonstrating poorer outcomes at low-volume hospitals.  Both of these are derived from decades of research showing that high surgical volumes are associated with better outcomes, especially in high-risk procedures.


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