In the era of skyrocketing health care costs, measuring value in the hospital setting has become crucial. Pancreatic cancer, a notoriously aggressive disease with complex management, has in recent years been aggregated to specialized medical centers. In this issue of JAMA Surgery, Bateni et al1 present a review of outcomes and cost after attempted curative resection for early-stage pancreatic adenocarcinoma. Data were obtained from the California Cancer Registry along with the Office of Statewide Hospital Planning and Development. Consistent with previous reports, the study1 showed that high-volume and National Cancer Institute–designated cancer centers have superior overall survival rates. However, on multivariable analysis, they found that, given the higher cost burden at these centers, the improved outcomes do not translate into high-value care.
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Massoumi RL, Hines OJ. Aggregating Pancreatic Cancer Care to Specialized Centers—A High-Value Decision? JAMA Surg. Published online August 21, 2019. doi:10.1001/jamasurg.2019.3020
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