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Hospital Procedure Volume and Outcomes
- Jeffrey A. Meyerhardt, MD; and
- Charles S. Fuchs, MD, MPH
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
IN RESPONSE:
Mr. Joshi and Dr. Miller note that both surgeon- and hospital-specific factors may be important predictors of outcome. The articles by Prystowsky and colleagues (1) and Ko and associates (2) examined the impact of such factors on short-term outcomes, particularly in hospital morbidity and mortality and length of stay. We were particularly interested in looking beyond short-term end points and examining whether the hospital where a colon cancer resection is performed predicts long-term mortality and cancer recurrences. Of interest, the number of surgeries was associated with overall mortality but not recurrences, suggesting that volume is a surrogate for a long-term outcome unrelated to the patient's colon cancer. In our database, we found no association between a hospital's affiliation with a medical school or the number of trainees at a hospital and either overall mortality or cancer recurrences. We did not have information on individual surgeons, although recent reports have demonstrated conflicting relative importance between hospital and surgeon volumes (3, 4). Furthermore, the recent movements toward regionalization and procedure volume thresholds have focused on hospital procedure volumes, thereby underscoring the need to further understand what such volumes truly mean.
Jeffrey A. Meyerhardt, MD
Charles S. Fuchs, MD, MPH
Dana-Farber Cancer Institute; Boston, MA 02115
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
