The Volume–Outcome Conundrum

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Abstract
There is considerable evidence that patients undergoing various types of complex treatments or high-risk surgical procedures have lower mortality rates and otherwise better outcomes if care is provided in hospitals that have a high caseload of patients with the same condition than if care is provided by institutions with low caseloads of such patients. Notwithstanding the fact that some low-volume institutions have good outcomes and some high-volume hospitals have relatively poor outcomes, this relation between high volume and better outcomes is strong and persistent, with approximately 300 studies on the subject having been reported in the English-language literature since the . . .