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Risk-Adjusted Mortality Rates as a Quality Proxy Outperform Volume in Surgical Oncology—A New Perspective on Hospital Centralization Using National Population-Based Data

Baum, Philip ; Lenzi, Jacopo ; Diers, Johannes ; Rust, Christoph ; Eichhorn, Martin E. ; Taber, Samantha ; Germer, Christoph-Thomas ; Winter, Hauke ; Wiegering, Armin


PURPOSE Despite a long-known association between annual hospital volume and outcome, little progress has been made in shifting high-risk surgery to safer hospitals. This study investigates whether the risk-standardized mortality rate (RSMR) could serve as a stronger proxy for surgical quality than volume. METHODS We included all patients who underwent complex oncologic surgeries in Germany ...


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