The effects of regionalization on cost and outcome for one general high-risk surgical procedure

Toby A. Gordon, Gregg P. Burleyson, James M. Tielsch, John L. Cameron

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The effects of regionalization of tertiary care were studied by analyzing cost and outcome for pancreaticoduodenectomies in a state in which the majority of these high-risk procedures were performed in one hospital. Methods: Using Maryland inpatient discharge data via a retrospective study, the authors compared cost and outcome data for a hospital with more than one half of the cases in the state to all other hospital providers as a group and with smaller groupings according to the volume of procedures performed. Results: Hospital mortality, length of stay, and costs were significantly less at the high-volume regional medical center when compared with all other hospitals. Mortality and cost increased as volume decreased when hospitals were grouped according to volume. Conclusions: An academic medical center, functioning as a high-volume regional provider, can deliver tertiary care services with improved outcomes at lower costs than community hospitals.

Original languageEnglish (US)
Pages (from-to)43-49
Number of pages7
JournalAnnals of surgery
Volume221
Issue number1
DOIs
StatePublished - Jan 1995

ASJC Scopus subject areas

  • Surgery

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