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This should include moving from volume to outcome, value-based payment models.
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Regionalization of complex visceral surgery across the US has followed identification of a volume to outcomes association.
Using my understanding of basic business principles across industries, I am now looking at health care as mentioned when I recently wrote here on Front Health, a startup that helps companies with the value of their healthcare by shifting focus from volume to outcomes.
Volume-to-outcomes relationships have been established for high-risk surgical procedures.
Although the volume-to-outcome relationship in CRC surgery seems smaller in magnitude than that in other digestive procedures, consideration must be given as to whether regionalization of CRC care is an appropriate mechanism for quality improvement [ 33].
There have been several studies of nasopharyngeal carcinoma (NPC) relating tumor volume to treatment outcome.
Further studies will be important in determining the relative importance of surgeon volume and hospital volume to TKA outcome.
Dunst and colleagues even described that the hypoxic tumor volume is a better prognosticator than total tumor volume to predict outcome after radiotherapy 71.
Indeed, the need to substantially reduce tidal volume to improve outcome in ARDS patients remains questionable because of the deleterious effects of hypercapnia [ 8].
Many believe that after proper training, experience (volume, years) and annual volume contribute to outcomes, but consensus on relative importance of annual volume vs cumulative experience, and on recredentialing volume thresholds, is lacking.
Uncertainty increases, however, when experts shift from thinking about outcomes in high-volume centres to outcomes in low-volume centres or among untreated women with fistula.
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Justyna Jupowicz-Kozak
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