Dr. Birkmeyer's current work is examining the role of clinical performance and patient preferences in decisions to regionalize major surgery. Using pancreatic surgery as a prototype, the goal is to develop a generalizable, three-component model for evaluating the expected value of different regionalization strategies: 1) volume-outcome study based on large administrative databases, 2) quantitative assessment of patient preferences for location of care, and 3) decision analysis and cost-effectiveness analysis incorporating clinical performance and patient preference data.