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ContextSurgical mortality rates are increasingly used to measure hospital quality. It is not clear, however, how many hospitals have sufficient caseloads to reliably identify quality problems.ObjectiveTo determine whether the 7 operations for which mortality has been advocated as a quality indicator by the Agency for Healthcare Research and Quality (coronary artery bypass graft [CABG] surgery, repair of abdominal aortic aneurysm, pancreatic resection, esophageal resection, pediatric heart surgery, craniotomy, hip replacement) are performed frequently enough to reliably identify hospitals with increased mortality rates.Design and SettingThe US national average mortality rates and hospital caseloads of the 7 operations were determined using the 2000 Nationwide Inpatient Sample (NIS), and sample size calculations were performed to determine the minimum caseload necessary to reliably detect increased mortality …