ArticleAnnals of surgery open : perspectives of surgical history, education, and clinical approaches2026
The Financial Argument for Centralization of Care for Esophagectomy.
Article in Annals of surgery open : perspectives of surgical history, education, and clinical approaches, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: To determine if spending is lower at high-volume esophagectomy centers. Background: There is growing enthusiasm for centralization of care for operations with strong volume-outcome relationships, such as esophagectomy. While justifications for centralization of care have traditionally relied on clinical outcomes, little is known about whether spending also differs at hospitals with varying levels of experience performing esophagectomy. Methods: We queried Medicare claims data for fee-for-service Medicare beneficiaries undergoing esophagectomy from 2011 to 2021. Centers were categorized as high-volume (≥20 cases/year) or low-volume (<20 cases/year), a threshold backed by a large body of evidence and patient safety organizations. We used generalized linear models, adjusting for patient demographics and comorbidities, to estimate price-standardized episode payments for low- and high-volume centers. Results: We identified 26,676 beneficiaries who underwent esophagectomy at 30 high-volume centers (7044 beneficiaries, 26.4%) and 1731 low-volume centers (19,632 beneficiaries, 73.6%) during the study period. Adjusted 90-day total episode spending was $62,305 [95% confidence interval: $61,239-$63,372] per beneficiary for high-volume centers; spending was 6.1% higher ($3781) at low-volume centers (total episode spending $66,087, 95% confidence interval: $65,362-$66,812), representing excess annual spending of $7.1 million. Index hospitalization, post-acute care, and readmission spending were also higher at low-volume centers. Low-volume centers had significantly higher rates of 90-day mortality and complications and longer length of stay. Conclusions: Compared to high-volume esophagectomy centers, Medicare spends more per episode at low-volume centers, possibly driven by readmissions and post-acute care utilization. Restricting esophagectomy to high-volume centers may both achieve safety and reduce spending.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.