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JNCI Journal of the National Cancer Institute 2006 98(3):151-154; doi:10.1093/jnci/djj055
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© The Author 2006. Published by Oxford University Press.

EDITORIAL

Transcending the Volume–Outcome Relationship in Cancer Care

Joseph Lipscomb

Correspondence to: Joseph Lipscomb, PhD, Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA 30322 (e-mail: jlipsco@sph.emory.edu).

The first 150 words of the full text of this article appear below.

Setting the Context

Research on the volume–outcome relationship in health care has generated both a high "volume" (more than 200 Medline-listed publications to date) and a consistently recurring "outcome": the finding that, across a range of interventional procedures, hospitals and surgeons with higher case loads tend to have lower mortality rates (1).

The volume–outcome relationship has been most striking for certain low-frequency, high-risk operations, such as pancreatectomy and esophagectomy. In particular, U.S. hospitals that performed 11 or more of the latter procedure on Medicare patients between 1984 and 1993 had a fivefold lower 30-day mortality rate (3.4% versus 17.3%) than hospitals that performed between one and five such procedures during the same period (2). In a review commissioned by the National Cancer Policy Board (NCPB) of the Institute of Medicine (IOM), Halm et al. (3) found that in 17 of 20 studies that involved cancers . . . [Full Text of this Article]

Breaking New Ground

Taking Stock


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