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Research Letter
December 26, 2019

Optimal Location for Centralization of Hospitals Performing Pancreas Resection in California

Author Affiliations
  • 1Veterans Affairs National Clinician Scholars Program, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
  • 2James Comprehensive Cancer Center, Division of Surgical Oncology, The Ohio State University Wexner Medical Center, Columbus
  • 3Deputy Editor, JAMA Surgery
JAMA Surg. 2020;155(3):261-263. doi:10.1001/jamasurg.2019.4937

There is an extensive body of research in complex cancer surgery that asserts a volume-outcome association in which patients are safer and have improved survival when their surgery is performed at hospitals and by surgeons with higher volume experience.1,2 This volume-outcome relationship has been especially true after resection for pancreatic cancer.3 As a consequence, organizations have advocated for minimum-volume standards and, as such, a centralization of complex cancer surgery operations. However, concerns about decreasing access to complex cancer surgery have been raised.4 Given this concern, we modeled what an optimal location-allocation market for hospitals performing pancreatic resections would look like, with the goal of maximizing market share while minimizing cannibalization and eliminating low-volume centers.

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