The 2021 China General Hospital Surgery Volume Ranking has been announced. What do you think of this ranking?

2021 Chinese Hospital Surgery Volume Ranking: The First Affiliated Hospital of Zhengzhou University ranks first, leading the second place by more than 11 surgeries. The First Affiliated Hospital of Zhengzhou University topped the list with 284,300 surgeries! The second-ranked hospital was Bethune First Hospital of Jilin University, with more than 110,000 fewer surgeries than the First Affiliated Hospital of Zhengzhou University. Ranking fourth is Henan Provincial People's Hospital, with a surgical volume of 158,000. The top two hospitals in Henan ranked first and fourth in terms of surgical volume in the country respectively. Due to the epidemic, the total number of visits to medical institutions nationwide in 2020 was 7.74 billion, a year-on-year decrease of 11.2%, and the number of admissions to medical and health institutions nationwide was 2,30130,000, a decrease of 35.83 million compared with the previous year ( decreased by 13.5%), and the annual hospitalization rate was 16.3%. It can be seen that among the top ten hospitals in the list, no hospital comes from the Beijing, Shanghai and Guangzhou areas where medical resources are concentrated. After calculation, the total number of surgeries performed by the top ten hospitals was 1583,000. The combined number of surgeries performed by the First Affiliated Hospital of Zhengzhou University and Henan Provincial People's Hospital was 442,300. The total number of surgeries performed by the two major hospitals in Henan accounted for 0.583 million surgeries nationwide. 27.94% of the top ten combined, which is a very high proportion. Industry insiders believe that the volume of hospital surgeries is related to the number of hospital beds, region and medical level. It can be found from the list that there are two Henan hospitals in the top 5. The First Affiliated Hospital of Zhengzhou University, ranked first, has the highest number of surgeries. Logically speaking, China's top hospitals are concentrated in Beijing, Shanghai, etc. Why is their surgical volume not proportional to their strength?