Association between surgeon specialization and mortality

Editor's Note

For four cardiovascular and four cancer procedures, surgeon specialization was an important predictor of operative mortality, independent of volume, this study finds.

Analyzing Medicare data for more than 25,000 surgeons and nearly 700,000 patients, the relative risk reduction from greater specialization in the cardiovascular procedures ranged from 15% for coronary bypass to 46% for valve replacement. The relative risk reduction in mortality for the cancer procedures ranged from 28% for lung resection to 48% for esophagectomy.

The implication is that a smaller, low-volume hospital/surgeon may be able to compensate by specializing, the authors say.

Objective To measure the association between a surgeon's degree of specialization in a specific procedure and patient mortality. Design Retrospective analysis of Medicare data. Setting US patients aged 66 or older enrolled in traditional fee for service Medicare.