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n of skills over time. The ForceSense parameters enable curricula to be designed for specific proficiency-based training goals and offer the possibility for objective classification of the levels of expertise. The objective of the current study was to assess the impact of case mix index at the hospital level on postoperative outcomes among Medicare beneficiaries who underwent hepatopancreatic surgery. Medicare beneficiaries who underwent hepatopancreatic surgery between 2013 and 2017 were identified and analyzed. The primary independent variable, Case Mix I
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