Regionalization of surgical services.

Using data from the Studies on Surgical Services for the United States (SOSSUS), the extent of existing surgical care regionalization was examined in a defined area. Specialist surgeons comprised 55 per cent of all physicians who did operations, but performed nearly three-fourths of all operative work. About one-third of the most complex operations (CRV greater than or equal to 30), more than one-fifth of medium complexity (CRV = 20-29), and 14 per cent of low complexity (CRV less than 20) were obtained out of county of residence. Nearly one-half of all surgical patients at the university hospital were from other counties; but for those obtaining the most complex operations (CRV greater than or equal to 30), three-fourths of them were from other counties. Thus there was a substantial amount of regionalization of surgical care already existing in this area.