health facility size


Summary: The physical space or dimensions of a facility. Size may be indicated by bed capacity.

Top Publications

  1. Nallamothu B, Saint S, Ramsey S, Hofer T, Vijan S, Eagle K. The role of hospital volume in coronary artery bypass grafting: is more always better?. J Am Coll Cardiol. 2001;38:1923-30 pubmed
    ..Targeted regionalization might be a feasible strategy for balancing the clinical benefits of regionalization with patients' desires for choice and access. ..
  2. Karanicolas P, Dubois L, Colquhoun P, Swallow C, Walter S, Guyatt G. The more the better?: the impact of surgeon and hospital volume on in-hospital mortality following colorectal resection. Ann Surg. 2009;249:954-9 pubmed publisher
  3. Gruen R, Pitt V, Green S, Parkhill A, Campbell D, Jolley D. The effect of provider case volume on cancer mortality: systematic review and meta-analysis. CA Cancer J Clin. 2009;59:192-211 pubmed publisher
  4. Hollenbeck B, Daignault S, Dunn R, Gilbert S, Weizer A, Miller D. Getting under the hood of the volume-outcome relationship for radical cystectomy. J Urol. 2007;177:2095-9; discussion 2099 pubmed
    ..9, 95% CI 0.4-8.6). Measurable differences in the availability and breadth of consultative, diagnostic and ancillary services may at least partially explain the association between procedure volume and short-term cystectomy outcomes. ..
  5. Bianco F, Riedel E, Begg C, Kattan M, Scardino P. Variations among high volume surgeons in the rate of complications after radical prostatectomy: further evidence that technique matters. J Urol. 2005;173:2099-103 pubmed
  6. Killeen S, O Sullivan M, Coffey J, Kirwan W, Redmond H. Provider volume and outcomes for oncological procedures. Br J Surg. 2005;92:389-402 pubmed
    ..High-volume providers have a significantly better outcome for complex cancer surgery, specifically for pancreatectomy, oesphagectomy, gastrectomy and rectal resection. ..
  7. Al Dawoud M, Thompson L, Al Khaffaf H. Evaluation of a telephone clinic for patients with intermittent claudication. Br J Nurs. 2009;18:495-7 pubmed
  8. Feldhahn L, Nachtrodt G. [Mortality and morbidity of very premature infants in Baden-Württemberg depending on hospital size. Is the current degree of regionalization adequate?]. Z Geburtshilfe Neonatol. 2006;210:153; author reply 153-4 pubmed
  9. Handford C, Rackal J, Tynan A, Rzeznikiewiz D, Glazier R. The association of hospital, clinic and provider volume with HIV/AIDS care and mortality: systematic review and meta-analysis. AIDS Care. 2012;24:267-82 pubmed publisher
    ..Heterogeneity of volume thresholds and absence of studies from resource-limited settings are major limitations. ..

More Information


  1. Regnier V, Denton A. Ten new and emerging trends in residential group living environments. NeuroRehabilitation. 2009;25:169-88 pubmed publisher
    ..Promising concepts of service organization and community outreach are combined with detailed recommendations that address the need for lift technology and safety features in bathrooms and kitchens. ..
  2. Dodek P, Keenan S, Norena M, Martin C, Wong H. Structure, process, and outcome of all intensive care units within the province of British Columbia, Canada. J Intensive Care Med. 2010;25:149-55 pubmed publisher
    ..Variation and lack of availability of key processes for care of critically ill patients in this population identifies opportunities for knowledge translation and systematic improvement including regionalization of care. ..
  3. Balzano G, Zerbi A, Capretti G, Rocchetti S, Capitanio V, Di Carlo V. Effect of hospital volume on outcome of pancreaticoduodenectomy in Italy. Br J Surg. 2008;95:357-62 pubmed
    ..Length of postoperative stay was reduced in very high-volume hospitals (P < 0.001). The outcome of PD in Italy is dependent on hospital volume and a policy of centralization may therefore be appropriate. ..
  4. Schofer M, Diehl A, Theisen C, Timmesfeld N, Heyse T, Fuchs Winkelmann S, et al. [Anterior shoulder instability--the current situation]. Z Orthop Unfall. 2010;148:83-9 pubmed publisher
    ..001). The operative shoulder stabilisation is most frequently carried out as arthroscopic Bankart repair. A standardised, subsequent treatment is well established. ..
  5. Harvey R, Jason L. Contrasting social climates of small peer-run versus a larger staff-run substance abuse recovery setting. Am J Community Psychol. 2011;48:365-72 pubmed publisher
    ..e., social control, social learning, behavioral economics, and stress and coping), which help account for effective substance abuse treatment environments. ..
  6. Pasquali S, Li J, Burstein D, Sheng S, O Brien S, Jacobs M, et al. Association of center volume with mortality and complications in pediatric heart surgery. Pediatrics. 2012;129:e370-6 pubmed publisher
  7. Cao Y, Li M, Guo Y. [Analysis of the design and renovation of mid-sized hospital's local area network]. Zhongguo Yi Liao Qi Xie Za Zhi. 2011;35:465-6, 469 pubmed
    ..create features of extensibility, manageability, high safety, stability and so on to the overall network, and provide a reliable network platform to the function of the information systems. ..
  8. Arroyo A, Ramirez J, Callejo D, Viñas X, Maeso S, Cabezali R, et al. Influence of size and complexity of the hospitals in an enhanced recovery programme for colorectal resection. Int J Colorectal Dis. 2012;27:1637-44 pubmed publisher
    ..The carrying out of protocol is greater in smaller and less complex hospitals and is directly related to a shorter stay in hospital. ..
  9. Tortorano A, Biraghi E, Astolfi A, Ossi C, Tejada M, Farina C, et al. European Confederation of Medical Mycology (ECMM) prospective survey of candidaemia: report from one Italian region. J Hosp Infect. 2002;51:297-304 pubmed
    ..Intravascular catheter removal was associated with higher survival rate (71 vs. 47%). This survey underscores the importance of candidaemia in hospital settings. ..
  10. Papadimos T, Habib R, Zacharias A, Schwann T, Riordan C, Durham S, et al. Early efficacy of CABG care delivery in a low procedure-volume community hospital: operative and midterm results. BMC Surg. 2005;5:10 pubmed
    ..This approach may prove a useful paradigm to ensure high quality CABG care and early efficacy at low volume institutions that wish to comply with the Leapfrog standards. ..
  11. Smith A, Thai J, Bakitas M, Meier D, Spragens L, Temel J, et al. The diverse landscape of palliative care clinics. J Palliat Med. 2013;16:661-8 pubmed publisher
    ..Once established, outpatient palliative care practices anticipate rapid growth. In this context, outpatient practices must plan for increased staffing and develop a sustainable financial model. ..
  12. Haj Mohammad N, Bernards N, van Putten M, Lemmens V, van Oijen M, van Laarhoven H. Volume-outcome relation in palliative systemic treatment of metastatic oesophagogastric cancer. Eur J Cancer. 2017;78:28-36 pubmed publisher
    ..Further research should be implemented to explore which specific factors of high-volume centres are associated with improved outcomes. ..
  13. McSwain N, Rotondo M, Meade P, Duchesne J. A model for rural trauma care. Br J Surg. 2012;99:309-14 pubmed publisher
  14. Castle N, Engberg J, Lave J, Fisher A. Factors associated with increasing nursing home closures. Health Serv Res. 2009;44:1088-109 pubmed publisher
    ..As states actively debate about how to redistribute long-term care services/dollars, our findings show that they should be cognizant of the potential these decisions have for facilitating nursing home closures. ..
  15. de Rooij A, Luijkx K, Schaafsma J, Declercq A, Emmerink P, Schols J. Quality of life of residents with dementia in traditional versus small-scale long-term care settings: a quasi-experimental study. Int J Nurs Stud. 2012;49:931-40 pubmed publisher
    ..Future research should focus more on the quality and content of the care provided, than on the effects of the scale and design of the environment in long-term care settings. ..
  16. Bergamini C, Martellucci J, Tozzi F, Valeri A. Complications in laparoscopic adrenalectomy: the value of experience. Surg Endosc. 2011;25:3845-51 pubmed publisher
    ..Therefore, laparoscopic adrenalectomy, especially for tumors that are potentially more complicated, should only be undertaken in high-volume specialist centers by surgeons with the appropriate training and experience. ..
  17. Jacquot J, Gony M, Baudrin D, Chastel X, Montastruc J, Bagheri H. [Could we improve notification of adverse drugs reactions in hospital? Assessment of 5 years of network PharmacoMIP's activities]. Therapie. 2012;67:231-6 pubmed publisher
    ..This study shows that regular visits increases the number of ADRs reported by non-university hospitals. Further assessment of this procedure is necessary for long term evaluation of its effectiveness. ..
  18. Nicholson W, Witter F, Powe N. Effect of hospital setting and volume on clinical outcomes in women with gestational and type 2 diabetes mellitus. J Womens Health (Larchmt). 2009;18:1567-76 pubmed publisher
    ..Further investigations are needed to explain variations in outcomes across hospital settings and volumes. ..
  19. Castle N. Differences in nursing homes with increasing and decreasing use of physical restraints. Med Care. 2000;38:1154-63 pubmed
    ..The organizational characteristics of these nursing homes differ from those that decreased their use of physical restraints. ..
  20. Lueg E. Comparing microvascular outcomes at a large integrated health maintenance organization with flagship centers in the United States. Arch Otolaryngol Head Neck Surg. 2004;130:779-85 pubmed
  21. Flowerdew R. Preanesthetic evaluation in private practice. Anesthesiol Clin North America. 2004;22:141-53 pubmed
    ..However, technology may require extensive support (time and money) to implement, but the indirect gains should justify the effort. ..
  22. Lee H, Tsai S, Lin H, Chen C. The association between psychiatrist numbers and hospitalization costs for schizophrenia patients: a population-based study. Schizophr Res. 2006;81:283-90 pubmed
    ..Further studies should aim to investigate the volume-quality relationship to ensure that incremental cost savings associated with increased patient volume are not achieved at the expense of quality of patient care. ..
  23. Friesner D, Rosenman R. Do hospitals practice cream skimming?. Health Serv Manage Res. 2009;22:39-49 pubmed publisher
    ..Using a panel of Washington state hospitals, we find evidence that hospitals do practice cream skimming. However, we find little evidence to suggest that cream skimming varies by hospital size, profit status or time. ..
  24. Rath T, Buscher G, Schwartze D, Drabik A, Bokern E, Lungen M. [Analysis of mortality and convergence tendencies in inpatient care of stroke and myocardial infarction]. Herz. 2010;35:389-96 pubmed publisher
    ..The reason for this could be the need to maintain emergency care in rural regions, while specialized centers are increasingly built in urban areas. ..
  25. Scott Cawiezell J, Jones K, Moore L, Vojir C. Nursing home culture: a critical component in sustained improvement. J Nurs Care Qual. 2005;20:341-8 pubmed
    ..Leaders, however, were more often reported to reflect a hierarchy value orientation, emphasizing efficiency of operations and following rules and procedures. ..
  26. Barbone G, Oreste N, Pagliarulo R, Verrastro P, Stanzione O, Dormio P, et al. Surgical and anesthesiological procedures and patients outcome in a major teaching hospital, in a major non-teaching hospital and in a minor hospital. Minerva Anestesiol. 2006;72:223-34 pubmed
    ..This study showed good results, but it should be repeated in a few years in order to evaluate any change and possible improvement in the management and outcome of the patients. ..
  27. Burton K, Slack R, Oldroyd K, Pell A, Flapan A, Starkey I, et al. Hospital volume of throughput and periprocedural and medium-term adverse events after percutaneous coronary intervention: retrospective cohort study of all 17,417 procedures undertaken in Scotland, 1997-2003. Heart. 2006;92:1667-72 pubmed
    ..Emergency surgery was less common in high-volume hospitals. Over two years, patients treated in high-volume centres were as likely to undergo some form of revascularisation but less likely to undergo surgery. ..
  28. Otake H, Yasunaga H, Horiguchi H, Matsutani N, Matsuda S, Ohe K. Impact of hospital volume on chest tube duration, length of stay, and mortality after lobectomy. Ann Thorac Surg. 2011;92:1069-74 pubmed publisher
    ..However, the differences in outcomes between high-volume and low-volume hospitals may be too small to support regionalization of lung cancer operations to high-volume centers. ..
  29. Hough D. Is bigger always better? The optimal size of a group practice. J Med Pract Manage. 2002;17:312-8 pubmed
    ..The article concludes with observations about the challenges to physician practices as they grow. ..
  30. Tzavellas P, Papilas K, Grigoropoulou I, Zolindaki C, Kouki P, Chrona H, et al. A survey of postoperative epidural and intravenous analgesia in Greece. Eur J Anaesthesiol. 2007;24:942-50 pubmed
    ..Implementation of acute pain services that are satisfying the quality criteria may help to improve patient care. ..
  31. Lawrence D. At your service. Mid-size hospital CIOs discuss the classic user-adoption question--who ultimately owns a system implementation?. Healthc Inform. 2007;24:42, 44, 46 passim pubmed
  32. Baird W, McGrother C, Abrams K, Dugmore C, Jackson R. Access to dental services for people with a physical disability: a survey of general dental practitioners in Leicestershire, UK. Community Dent Health. 2008;25:248-52 pubmed
  33. Bao Y, Kamble S. Geographical distribution of surgical capabilities and disparities in the use of high-volume providers: the case of coronary artery bypass graft. Med Care. 2009;47:794-802 pubmed publisher
    ..Factors other than availability of surgical resources were responsible for differences between Medicaid/uninsured and privately insured patients. ..
  34. Nordin P, van der Linden W. Volume of procedures and risk of recurrence after repair of groin hernia: national register study. BMJ. 2008;336:934-7 pubmed publisher
    ..Volume indicates an approximate minimum value for the number of hernia repairs a surgeon should do each year but the outcome in surgeons who carry out more than that number disqualifies volume as an indicator of proficiency. ..
  35. Bergelt C, Schölermann C, Hahn I, Weis J, Koch U. [Psychooncological care for breast cancer patients in hospitals and in the outpatient sector]. Gesundheitswesen. 2010;72:700-6 pubmed publisher
    ..The heterogeneity in outpatient psycho-oncological care can be interpreted as desirable diversity which allows for the consideration of the varying needs of patients with different diagnoses, disease stages, and treatments. ..
  36. Chen L, Zhang W, Sun J, Mueller K. The magnitude, variation, and determinants of rural hospital resource utilization associated with hospitalizations due to ambulatory care sensitive conditions. J Public Health Manag Pract. 2009;15:216-22 pubmed publisher
    ..Health intervention programs and health policies should be designed to increase access to and utilization of appropriate preventive and primary healthcare in rural areas, especially in small and remote communities. ..
  37. Chen L, Staiger D, Birkmeyer J, Ryan A, Zhang W, Dimick J. Composite quality measures for common inpatient medical conditions. Med Care. 2013;51:832-7 pubmed publisher
    ..001). Results were similar for HF and PNA. Composite measures of quality for HF, AMI, and PNA performed better than existing measures at explaining variation in future mortality and predicting future high and low performers. ..
  38. Fleetcroft R, Steel N, Cookson R, Walker S, Howe A. Incentive payments are not related to expected health gain in the pay for performance scheme for UK primary care: cross-sectional analysis. BMC Health Serv Res. 2012;12:94 pubmed publisher
    ..When designing pay for performance programmes decisions about the size of the financial incentive attached to an indicator should be informed by information on the health gain to be expected from that indicator. ..
  39. Zuckerman A. What would you do? Is this system's smaller hospital a keeper?. Healthc Financ Manage. 2008;62:112, 114 pubmed
  40. Somme S, To T, Langer J. Factors determining the need for operative reduction in children with intussusception: a population-based study. J Pediatr Surg. 2006;41:1014-9 pubmed
    ..These data underline the importance of early diagnosis and timely management of intussusception. ..
  41. Mock C, Nguyen S, Quansah R, Arreola Risa C, Viradia R, Joshipura M. Evaluation of Trauma Care capabilities in four countries using the WHO-IATSIC Guidelines for Essential Trauma Care. World J Surg. 2006;30:946-56 pubmed
    ..It also has demonstrated the usefulness of the Guidelines for Essential Trauma Care in providing an internationally applicable, standardized template by which to assess trauma care capabilities. ..
  42. Mesman J. The geography of patient safety: a topical analysis of sterility. Soc Sci Med. 2009;69:1705-12 pubmed publisher
    ..As such, a topical analysis offers an alternative perspective of patient safety, one that takes into account its spatial dimension. ..
  43. Berthelsen H, Hjalmers K, Soderfeldt B. Perceived social support in relation to work among Danish general dental practitioners in private practices. Eur J Oral Sci. 2008;116:157-63 pubmed publisher
    ..This study emphasized the importance of the organizational setting for a professional and personal supportive psychosocial working environment in dentistry. ..
  44. Gort M, Otter R, Plukker J, Broekhuis M, Klazinga N. Actionable indicators for short and long term outcomes in rectal cancer. Eur J Cancer. 2010;46:1808-14 pubmed publisher
  45. Lin N, Cahill K, Frerichs K, Friedlander R, Claus E. Treatment of ruptured and unruptured cerebral aneurysms in the USA: a paradigm shift. J Neurointerv Surg. 2012;4:182-9 pubmed publisher
    ..Although surgical clipping is used for treatment of most ruptured aneurysms, its use is decreasing over time. Dissemination of endovascular procedures appears widespread across patient and hospital subgroups. ..
  46. Baker G, Norton P, Flintoft V, Blais R, Brown A, Cox J, et al. The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. CMAJ. 2004;170:1678-86 pubmed
    ..5% in our study suggests that, of the almost 2.5 million annual hospital admissions in Canada similar to the type studied, about 185 000 are associated with an AE and close to 70 000 of these are potentially preventable. ..
  47. Estabrooks C, Midodzi W, Cummings G, Wallin L. Predicting research use in nursing organizations: a multilevel analysis. Nurs Res. 2007;56:S7-23 pubmed
    ..Such investigations will require careful attention to both methodological and interpretative challenges present when dealing with multiple units of analysis. ..
  48. West R, Cattle B, Bouyssie M, Squire I, de Belder M, Fox K, et al. Impact of hospital proportion and volume on primary percutaneous coronary intervention performance in England and Wales. Eur Heart J. 2011;32:706-11 pubmed publisher
  49. Fernandez Hidalgo N, Almirante B, Tornos P, González Alujas M, Planes A, Larrosa M, et al. Prognosis of left-sided infective endocarditis in patients transferred to a tertiary-care hospital--prospective analysis of referral bias and influence of inadequate antimicrobial treatment. Clin Microbiol Infect. 2011;17:769-75 pubmed publisher
    ..3, 95% CI 1.1-10.0, p?0.030). Errors in the initial antimicrobial treatment prescribed for LSIE are associated with greater mortality. ..
  50. Kapiteijn E, van de Velde C. Developments and quality assurance in rectal cancer surgery. Eur J Cancer. 2002;38:919-36 pubmed
    ..This article reviews developments in the treatment of especially mobile rectal cancer and pays attention to variability in outcomes and quality assurance of surgery. ..
  51. Zehetner J, Leidl S, Wuttke M, Wayand W, Shamiyeh A. Conversion in laparoscopic cholecystectomy in low versus high-volume hospitals: is there a difference?. Surg Laparosc Endosc Percutan Tech. 2010;20:173-6 pubmed publisher
    ..There was no difference in the postoperative complication rate and reoperation rate between a LVH and a HVH. There is no difference in conversion rate in LC in LVHs versus HVHs. The quality of LC and even CC is similar in LVH and HVH. ..
  52. Neuhauser D. Surgical experience, hospital size and severity adjusted mortality: James Y Simpson, 1869. Qual Saf Health Care. 2005;14:67-8 pubmed
  53. Hartley D, Loux S, Gale J, Lambert D, Yousefian A. Characteristics of inpatient psychiatric units in small rural hospitals. Psychiatr Serv. 2010;61:620-3 pubmed publisher
    ..Thus mental health services infrastructure appears better in these communities than in most rural communities, but it may be weakened by recent closures reported by some units, caused, in part, by changes in Medicare reimbursement. ..