OBJECTIVES: In this paper we analyze the volume-outcome relationship for patients with intact abdominal aortic aneurysm (AAA) and hip fracture (HIP) and define hypothetical minimum volume standards to assess changes in access. METHODS: The analysis is based on administrative data coming from the German system of diagnosis related groups of about 18.6 million hospital cases of 1,780 German hospitals for the year 2007. The data includes detailed information on patient characteristics used for risk-adjustment. Furthermore, we have a ZIP-code for each patient and the exact address for every hospital. Addresses of hospitals and the centroids of all German ZIP codes were geo-coded. For the empirical analysis, we use multiple logistic regression analysis. We supplement our analysis by showing changes in access to hospitals if a minimum volume standard is introduced. RESULTS: Patients with hip fracture who are treated in hospitals with less than 58 cases per year have an average probability of death of 5.1 % compared to an average mortality of 3.1 % for patients who are treated in hospitals with more than 151 cases. For patients with AAA the case volume effect is lower. However, compared to patients treated in hospitals with less than 15 cases per year, the average probability of death for patients treated in hospitals with more than 68 cases is 1.0 percentage points less. We show that minimum volume standards seem possible without compromising overall access. CONCLUSIONS: The estimation results suggest that around 380 deaths could have been presumably avoided, if around 20,000 patients in the smallest hospitals would have been treated in the largest hospitals instead. Furthermore, we show that minimum volume standards do not compromise overall access measured in travel times. However, to ensure an adequate access in all areas, a few “sole providers” in some regions seem necessary.