There are a number of studies indicating that surgery performed at high volume centers is associated with better outcomes than those performed at low volume centers. This study, however, indicates that it has more to do with the reliability of the system than the volume. In this large retrospective analysis of over 80,000 patients who underwent a CABG, researchers found a strong association between death, and the number of peri-operative quality measures missed (SCDs, beta blocker, ASA, statin, any antibiotic, and appropriate antibiotic), which was independent of hospital or surgeon volume. This indicates that the quality reliability of the hospital system is more important than the volume of the hospital system (abstract). The authors offer that it may be better to “shop for the best” instead of “following the crowd”
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