Accepted for Publication: August 22, 2013.
Published Online: March 12, 2014. doi:10.1001/jamasurg.2013.5076.
Study concept and design: Birkmeyer, Dimick, Ghaferi.
Acquisition, analysis, and interpretation of data: All authors.
Drafting of the manuscript: All authors.
Critical revision of the manuscript for important intellectual content: Reames, Dimick, Ghaferi.
Statistical analysis: All authors.
Obtained funding: Dimick.
Administrative, technical, or material support: Dimick.
Study supervision: Dimick, Ghaferi.
Conflict of Interest Disclosure: Dr Birkmeyer has no conflicts of interest outside those of her husband, who is chief scientific officer of ArborMetrix Inc. ArborMetrix had no role in conducting this research or creating this manuscript. Dr Dimick is a consultant and has an equity interest in ArborMetrix Inc, which provides software and analytics for measuring hospital quality and efficiency. No other disclosures were reported.
Funding/Support: Dr Reames is supported by grant 5 T32 CA-009672-23 from the National Institutes of Health.
Role of the Sponsor: The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Previous Presentation: This work was presented at the Academy Health Annual Meeting; June 12, 2011; Seattle, Washington.