Hospital volume and surgical outcomes for elderly patients with colorectal cancer in the United States

Recent emphasis has been placed on the quality of surgical care in the United States. As such, patients, providers, and payers are increasingly aware of the outcomes of surgical care as a marker of quality. The objective of this study was to determine the impact of hospital volume on mortality for patients of different age groups to determine whether elderly patients would derive more benefit from selective referral policies. Data from the Nationwide Inpatient Sample for all patients undergoing surgery for colorectal cancer during 1997 were obtained ( N = 20,862). Differences in mortality associated with increasing age and hospital volume quartiles were determined. Risk-adjusted analyses of mortality were performed using multiple logistic regression. The overall mortality rate was 3.1% for the 842 hospitals included. Patient age breakdown was the following: age 80, 22%. Increasing age was associated with higher mortality rates: age 80, 6.9%. Overall, the highest volume hospitals (HVH) (>150/year) had lower mortality than the lowest volume hospitals (LVH) (