Association of Discretionary Hospital Volume Standards for High-Risk Cancer Surgery With Patient Outcomes and Access, 2005-2016

Regionalization of care for complex problems remains an open question in most countries. This review demonstrated that, for high risk cancer operations in the US, the Leapfrog group's volume standards did not differentiate between surgical mortality outcomes for lung and esophageal cancer surgery. However, differences were evident comparing lowest and highest volume quintiles for operative mortality associated with these procedures. The percentage of hospitals meeting Leapfrog volume criteria increased for lung cancer surgery but recently decreased for esophageal cancer surgery; the latter finding is a reversal of an organic trend towards regionalization of esophageal cancer care over the prior decade and is of concern.