Treatment Facility Case Volume and Disparities in Outcomes of Congenital Diaphragmatic Hernia Cases
Topic overview
Texas statewide study (2013-2021) examining congenital diaphragmatic hernia outcomes across 93 hospitals. High-volume centers achieved lower mortality (18% vs 27%) despite treating sicker patients, while low-volume centers disproportionately served Hispanic populations along the Mexico border, revealing significant volume-outcome relationships and potential healthcare disparities.
Key takeaways
- Higher-volume CDH centers (>75 cases) achieve 18% mortality vs 27% at low-volume centers despite treating sicker patients.
- Each additional CDH case treated per facility correlates with 0.5% decreased mortality odds, supporting volume-outcome relationship.
- ECMO for CDH is primarily available at high-volume centers, limiting access for patients at smaller facilities.
- Hispanic and Mexican border populations are disproportionately treated at low-volume centers with worse outcomes.
- Regionalization of CDH care to high-volume centers may reduce mortality disparities in congenital diaphragmatic hernia.
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