Daniel Boffa, MD Professor of Surgery Yale School of Medicine

Surgical Safety Variations With Affiliation to a Top-Ranked Cancer Hospital

MedicalResearch.com Interview with:

Daniel Boffa, MD Professor of Surgery Yale School of Medicine

Dr. Boffa

Daniel Boffa, MD
Professor of Surgery
Yale School of Medicine 

MedicalResearch.com: What is the background for this study?

Response: We have previously demonstrated that top-ranked hospitals are significantly safer than their affiliates for complex cancer surgery (patients 1.4 times more likely to die after cancer surgery at affiliate hospitals).  A logical extension of this work was to compare affiliate hospitals to hospitals that were not affiliated with a top ranked hospital.

MedicalResearch.com: What are the main findings?

Response: We found that hospitals that affiliate with top-ranked cancer hospitals have a modest safety advantage over hospitals that are not affiliated (patients 1.1 times more likely to die after complex cancer surgery at hospitals that were not affiliated).

We next looked to see if we could identify improvements at affiliate hospitals that followed the formation of an affiliation with a top-ranked hospital.  We failed to identify any change at affiliate hospitals that occurred as a result of affiliation.  It appeared that top-ranked hospitals were selectively affiliating with the safer (unranked hospitals).

MedicalResearch.com: What should readers take away from your report?

Response: There are important differences in surgical safety within and outside of the networks that form around top-ranked hospitals.  While top-ranked hospitals appear to offer the safest option, their affiliates may be somewhat safer than hospitals that are not affiliated with a top ranked cancer hospital.  Patients should not make assumptions regarding the safety of surgical care based exclusively on the presence or absence of a prestigious hospital brand.

Patients should investigate the experience and safety of their hospital options before committing to a particular hospital for complex cancer surgical care.

I have no disclosures related to this study.

Epic Sciences has run research assays for my biomarker studies at no cost.


Resio BJ, Hoag JR, Chiu AS, et al. Variations in Surgical Safety According to Affiliation Status With a Top-Ranked Cancer Hospital. JAMA Oncol. Published online July 11, 2019. doi:10.1001/jamaoncol.2019.1808 

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Last Updated on July 12, 2019 by Marie Benz MD FAAD