1Nomun hospital
2Health Sciences University of Mongolia
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The volume-outcome relationship has been widely discussed over past decades. Although previous studies that examined the volume-outcome relationship show that the majority of these works support the reverse relationship of volume and outcome on various procedures, other studies reported inconsistent results and arguments if volume is robust enough to predict outcome. Therefore, extending volume outcome association to measuring efficiency as well as process quality of care, and linking the performance with outcome have been important issues not to health purchasers, but also providers and consumers when pursuing cost containment and quality improvement in health care industry. The purpose of this study is to review studies on the relationship between volume and outcome, and to identify possible measurements and methods. The large quantity of literature reported surgical volume-outcome relationship, but several limitations of those studies also have criticized and should be explored and re-verified. First, surgical volume was argued as a proxy of experience of surgeon and higher volume cannot naturally guarantee better outcome. Second, since the health care purchasers have drawn attention to the concept of pursuing value in health care, the efficiency of providers and the quality of care delivered should be measured instead of cost or volume alone. In addition, some specific possible outcome indicators should be considered in studies of the relationship between surgeons volume and outcome in future.
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