Interpreting the Volume-Outcome Relationship in the Context of Health Care Quality: Workshop Summary (2000)

9:00 a.m.–9:30 a.m.

Welcome and introduction: Diana Petitti

Opening remarks: John Eisenberg

9:30 a.m.–12:15 p.m.

Overview of the Volume-Outcome Relationship

Opening remarks: Mark Chassin

9:30 a.m.–10:30 a.m.

Presentation of background paper: “Synthesis of Evidence from the Literature,” Ethan Halm

10:30 a.m.–10:45 a.m.

Coffee break

10:45 a.m.–12:15 p.m.

Roundtable discussion Moderators: Mark Chassin and Jane Sisk

• Is the association consistent across conditions/procedures/services?

• What factors might explain the association?

• What measurement issues need to be addressed (e.g., defining volume, thresholds/cutpoints, units of analysis)?

• Does the evidence support applying volume as a quality-of-care measure?

• What additional research is needed?

Reactors/discussants: Edward Hannan, Norman Hertzer, Colin Begg, Bruce Hillner, Arnold Milstein

12:15 p.m.–l:15 p.m.

Lunch

1:15 p.m.–3:30 p.m.

Policy implications Opening remarks: Diana Pettiti

1:15 p.m.–l :45 p.m.

Presentation of background paper—“When and How Could Volume Be Used as an Indicator of Quality Care? ” Adams Dudley

1:45 p.m.–3:30 p.m.

Roundtable discussion Moderators: Don Berwick and Robert Galvin

• What level of evidence is needed to support policies?

• What are the strengths and weaknesses of alternative implementation strategies?

• What are the potential barriers to applying volume as an indicator of quality (e.g., access in rural areas, patient preferences for care close to home)

• What policy-relevant health services research is needed?

Reactors/discussants:

• Consumer perspectives: Art Levin and Ellen Stovall

• Purchaser perspectives: Bruce Bradley, Steven Clauser, and Irene Fraser

• Managed care: George Isham and Sam Ho

• Provider groups: Don Nielsen

3:30 p.m.–4:00 p.m.

Where do we go from here?

Moderator: Joseph Simone

Wrap-up: Discussion of findings and research needs

4:00 p.m.

Workshop Adjourns