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Editorial
June 23, 2008

Evaluating Quality in Small-Volume Hospitals

Arch Intern Med. 2008;168(12):1249-1251. doi:10.1001/archinte.168.12.1249

An unsolved question in health care quality measurement is how to assess the performance of hospitals and physicians with small volumes of patients.1 Evaluating hospitals with limited information is akin to judging a baseball player's hitting performance based on only a few games. Major League Baseball publishes all players' batting averages,2 but it considers only players with at least 502 plate appearances over a season when ranking top individual batting performances.3 Unlike most baseball players, many hospitals with small volumes may never accumulate enough data to support an accurate evaluation. What should we do?

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