Hospital Volume and 30-Day Mortality for Three Common Medical Conditions

• Published in: The New England journal of medicine Vol. 362; no. 12; pp. 1110 - 1118
• Main Authors: Ross, Joseph S, Normand, Sharon-Lise T, Wang, Yun, Ko, Dennis T, Chen, Jersey, Drye, Elizabeth E, Keenan, Patricia S, Lichtman, Judith H, Bueno, Héctor, Schreiner, Geoffrey C, Krumholz, Harlan M
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 25.03.2010
• Subjects: Aged; Biological and medical sciences; Clinical outcomes; Cross-Sectional Studies; Epidemiology; General aspects; Heart attacks; Heart Failure - mortality; Hospital Bed Capacity; Hospital Mortality; Hospitalization; Hospitalization - statistics & numerical data; Hospitals; Hospitals - classification; Hospitals - utilization; Hospitals, Teaching; Humans; Logistic Models; Medical sciences; Medicare; Mortality; Myocardial Infarction - mortality; Pneumonia - mortality; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Adjustment; United States - epidemiology; United States; Medicine; Hospital; Volume; Epidemiology; Mortality
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMsa0907130

The association between hospital volume and patient mortality has been established for some surgical procedures but is unclear for medical conditions. In this analysis of claims data from Medicare beneficiaries who were hospitalized for acute myocardial infarction, heart failure, or pneumonia, admission to higher-volume hospitals was associated with lower mortality. In this analysis of claims data from Medicare beneficiaries who were hospitalized for acute myocardial infarction, heart failure, or pneumonia, admission to higher-volume hospitals was associated with lower mortality. The relationship between hospital volume and patient mortality for acute myocardial infarction, heart failure, and pneumonia in the United States is unclear. Admission to higher-volume hospitals has been associated with a reduction in mortality for numerous surgical conditions and medical procedures 1 but not for common medical conditions. Two studies examining acute myocardial infarction showed that admission to higher-volume hospitals was associated with reduced mortality, 2 , 3 although both studies were performed before the adoption of improvements in computational power that account for the clustering of patients' outcomes within hospitals and key advances in clinical cardiology, including the widespread use of fibrinolytic . . .