The volume-outcome relationship has been a commonly invoked policy initiative aimed at improving the quality of healthcare. This inverse relationship between the caseload volume of patients treated and patient mortality has been described across many health settings and in many countries. Despite the large body of literature demonstrating this favourable relationship, most studies have focused on differentiating the effects of selective referral and the true effects of volume. In comparison, there are few studies evaluating the underlying mechanism of the volume-outcome relationship, namely dynamic learning-by-doing or the static effect of economics of scale. Resolving this tension between policies that allow providers to accrue experience over time and policies that promote centralisation of services would make a more compelling argument for policies such as minimum volume standards to be firmly established.
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Center for Health System Sustainability
Ritesh Maharaj MD, Ph.D.
Visiting Assistant Professor of Health Services, Policy, and Practice
Biography
Ritesh Maharaj is a critical care physician at King’s College Hospital, London with previous teaching experience at the King’s College London School of Medicine. His research focuses on the organization of health services and its impact on health outcomes. He focuses on critical care services and the effects of centralization, specialization and organizational learning. He is currently researching the supply of critical care services and its impact on mortality.