Should we regionalize major surgery? potential benefits and policy considerations1

aCenter for the Evaluative Clinical Sciences and the Departments of Surgery, Dartmouth Medical School, Hanover, NH, USA bVA Outcomes Group, Department of Veterans Affairs Medical Center, White River Junction, VT, USA Correspondence address: John D Birkmeyer, MD, FACS, VA Outcomes Group (111B), Department of Veterans Affairs Medical Center, White River Junction, VT 05009 Submitted August 11, 1999; revised and accepted October 7, 1999. Dr Birkmeyer is supported by a Career Development Award from the VA Health Services Research and Development program and a grant from the Agency for Health Care Policy and Research (RO1 HS10141-01). The views expressed herein do not necessarily represent the views of the Department of Veterans Affairs or the United States Government. 1No competing interests declared.