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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.1 This followed an announcement by US News & World Report of a new analysis demonstrating poorer outcomes at low-volume hospitals.1 Both of these are derived from decades of research showing that high surgical volumes are associated with better outcomes, especially in high-risk procedures.2,3
Chhabra KR, Dimick JB. Hospital Networks and Value-Based PaymentFertile Ground for Regionalizing High-Risk Surgery. JAMA. 2015;314(13):1335-1336. doi:10.1001/jama.2015.9803