Disparities in Surgical Outcomes and Hospital Volume

描述（由申请方提供）：本研究建议通过评估高容量和低容量医院的手术结局以及在每种医院类型接受治疗的患者人群，检查获得医疗保健的不平等。 已经确定，在高容量医院进行的复杂外科手术的死亡率显著降低。 目前尚不清楚的是，不同种族、社会经济地位和保险范围的患者是否能平等地进入高容量医院。本研究将创建在高容量和低容量医院进行的复杂外科护理程序（胰腺癌的胰腺切除术、食管癌的食管切除术、结肠癌的结肠切除术和肺癌的肺切除术）的数据集，并检查在每种类型医院接受护理的患者人群的特征。

DESCRIPTION (provided by the applicant): This study proposes the examination of inequalities in access to health care by evaluating the surgical outcomes at high- and low-volume hospitals and the patient populations that receive care at each hospital type. It has been established that mortality is significantly decreased for complex surgical procedures performed at high volume hospitals. What remains unknown is whether high volume hospitals are equally accessible to patients of different race, socioeconomic status and insurance coverage. This study will create a data-set of complex surgical care procedures (pancreatectomy for pancreatic cancer, esophageal resection for esophageal cancer, colectomy for colon cancer and lung resection for lung cancer) done at both high and low volume hospitals and examine the characteristics of the patient population that receives care at each type of hospital.