Regionalizing some surgical procedures would not result in unreasonable travel burdens o...( atectomy; 2/year for esophagectomy) ap...),Health

atectomy; 2/year for esophagectomy), approximately 15 percent of patients would change to higher-volume centers, with negligible effect on their travel times," the authors found. "Most patients would need to travel less than 30 additional minutes (74 percent pancreatectomy; 76 percent esophagectomy). Many patients (about 25 percent) already lived closer to a higher-volume hospital (25 percent pancreatectomy; 26 percent esophagectomy). Conversely, with very high-volume standards (more than 16/year for pancreatectomy; more than 19/year for esophagectomy), approximately 80 percent of patients would change to higher-volume centers. More than 50 percent of these patients would increase their travel time by more than 60 minutes. Travel times would increase most for patients living in rural areas."

"Many patients travel past a higher-volume center to undergo surgery at a low-volume hospital. If not set too high, hospital volume standards could be implemented for selected operations without imposing unreasonable travel burdens on patients," the authors conclude. (JAMA. 2003;290:2703-2708. Available post-embargo at JAMA.com)

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Contact: Deborah Kimbell
603-653-1913
JAMA and Archives Journals
25-Nov-2003

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