Epidemiologia e prevenzioneJul 16, 2013

Hospital patient numbers and health outcomes: evidence from reviews and Italian hospital data

Updated Dec 29, 2025

Abstract

A positive link between higher hospital activity and better patient outcomes was found for 26 clinical areas.

Higher volumes of care may lead to lower intrahospital and 30-day mortality rates for many conditions.
Positive associations were identified for conditions like AIDS, coronary angioplasty, and various cancer surgeries.
No significant association was found for hip arthroplasty and rectal cancer surgery.
Ten clinical areas lacked sufficient evidence to draw firm conclusions about the volume-outcome relationship.
The data suggests that effective health care may depend on establishing minimum care volumes for specific procedures.

Simplified

Improving quality and effectiveness of health care is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with a relevant impact on effectiveness of health care. A recent Italian law, the "spending review", calls for the definition of "qualitative, structural, technological and quantitative standards of hospital care". There is a need for an accurate evaluation of the available scientific evidence in order to identify these standards, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific health care interventions. Since 2009, the National Outcomes Programme evaluates outcomes of care of the Italian hospitals; nowadays it represents an official tool to assess the National Health System (NHS). In addition to outcome indicators, the last edition of the Programme (2013) includes a set of volume indicators for the conditions with available evidence of an association between volume and outcome. The assessment of factors, such as volume, that may affect the outcomes of care is one of its objectives.

Abstract

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