Volume/Outcome Relationships in Small Rural Hospitals

Abstract
This article summarizes a study of relationships between hospital volume and patient outcomes for diagnoses commonly treated and procedures commonly performed in smaller rural hospitals. Literature review findings and results of analyses using secondary data for several conditions suggest few if any volume/outcome relationships (with mortality being the main outcome for which data were available). A basic finding of the study is that most conditions and procedures for which volume effects on mortality have been found typically do not pertain to small rural hospitals. However, the available secondary data are weak, and many conditions and procedures have not been studied for small rural hospitals. Therefore, continued monitoring and review are important, as well as improved data systems, further research, and information dissemination on volume/outcome relationships. In particular, examining relationships between volume and outcomes in addition to mortality is critical to a thorough understanding of this topic.