Hospital Volume and the Outcomes of Mechanical Ventilation

In this study of more than 20,000 nonsurgical patients receiving mechanical ventilation at 37 acute care hospitals from 2002 to 2003, higher hospital volume was associated with improved survival. After adjustment for the severity of illness and the characteristics of the hospitals, mortality in the hospital was 34 percent in hospitals in the lowest quartile in terms of the number of patients receiving mechanical ventilation per year and 26 percent in the highest quartile. In more than 20,000 nonsurgical patients receiving mechanical ventilation at 37 acute care hospitals from 2002 to 2003, higher hospital volume was associated with improved survival. The association between the number of patients treated in a hospital (hospital volume) and patient outcome is well established for numerous medical and surgical conditions. 1 This relationship has been extensively documented in the surgical literature, where higher patient volume is associated with improved survival in situations involving trauma care, cardiac surgery, ruptured aortic aneurysms, and several types of cancer surgery. 2 – 6 Select medical conditions, including acute myocardial infarction 7 and the acquired immunodeficiency syndrome, 8 are also thought to have outcomes related to the volume of patients seen. Reasons for the relationship between volume and outcome in health care are unknown but . . .