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However, there is still a debate about the level of evidence of these studies and the appropriateness of minimum volume thresholds for high-risk surgical procedures.
As part of its "Evidence-Based Hospithe ReferraLeapfrog Group the Leapfrog Group, a coalition of large health care purchasers that insure 34 million Americans, recommended until 2003 that its members contract for selected procedures, including CABG and PCI, only with hospitals that met minimum volume thresholds [ 6].
The need for minimum volume thresholds for urological cancer surgery has been recognised by surgeons [ 41] and in England the National Institute for Clinical Excellence NICEE) recommends that RP should be provided by specialised teams typically carrying out 50 or more operations per annum [ 42].
1 2 3 4 5 6 7 8 On the basis of these data many payers and purchasers most visibly an assortment of private sector businesses in the United States have organised into the Leapfrog Group coalition to advocate for minimum volume thresholds for hospitals carrying out many complex procedures.
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The nationwide implementation of a hospital volume minimum policy for cardiovascular procedures based on volume thresholds promoted by the Leapfrog Group [ 7] would have required the annual redistribution of more than 231,000 patients who underwent CABG or PCI at low volume hospitals between 1998 and 2001.
The surgical concept of FLR could be adapted for application to RE, with thresholds to be defined for both the minimum volume of and the maximum dose to 'unirradiated functional liver'.
Equation (25) denotes the minimum volume flow necessary for voice onset, which has recently been called the phonation threshold volume flow (PTF) [26], [56], [57].
Calculated minimum volume fraction of nanotubes required for the simulated composite to become electrically conductive, known as the percolation threshold [15], was found to be around 1 %, which is lower than the experimentally observed threshold.
Adoption of volume thresholds may unwittingly motivate providers to treat patients with borderline indications in order to meet volume minimums.
Minimum volume (m3).
The Federal Joint Committee updates the minimum volume regulation.
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