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Related Experiment Videos

Does volume really affect outcome? Lessons from the evidence.

A J Sowden1, T A Sheldon

  • 1University of York, UK.

Journal of Health Services Research & Policy
|June 6, 1998
PubMed
Summary
This summary is machine-generated.

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The link between higher patient volume and better health service quality may be an artifact. Further research is needed to reliably inform health policy on provider credentialing and service configuration.

Area of Science:

  • Health Services Research
  • Healthcare Quality Improvement
  • Medical Policy

Background:

  • A common belief suggests concentrating patient care with high-volume providers improves health service quality.
  • Existing research often indicates a positive relationship between provider volume and quality outcomes.

Purpose of the Study:

  • To critically evaluate the evidence supporting the volume-quality relationship in healthcare.
  • To identify limitations in current research methodologies that may confound volume-quality findings.
  • To assess the reliability of existing research for informing health policy decisions.

Main Methods:

  • Review and critique of observational studies using administrative databases.
  • Analysis of confounding factors, including case-mix adjustment.

Related Experiment Videos

  • Examination of outcome measurement, clinician vs. hospital level analysis, and causality.

    • Main Results:

    • The presumed volume-quality effect may be an artifact due to inadequate adjustment for confounding variables.
    • Limitations in outcome measurement and analysis hinder clear interpretation.
    • Causality in the volume-quality relationship remains unclear.

    Conclusions:

    • Current evidence is often unreliable for policy decisions regarding provider credentialing or service reconfiguration based on volume.
    • Methodological improvements are necessary for robustly establishing the volume-quality link.
    • Further research with better controls and outcome measures is essential.