Surgical Survival Predictors May Be Next Big Quality Metric

Cheryl Clark, for HealthLeaders Media , May 19, 2011

The idea is to give healthcare purchasers a sense of their chances of having a bad outcome, and to give employers more information when they're deciding how to spend their health plan dollars.

Yes, giving discharge instructions, complying with antibiotic selection rules,  and giving patients a positive experience – the metrics being rolled out by the Centers for Medicare & Medicaid Services this year —are important.

But the bottom line is what everyone really wants to know. What is the chance a patient might die during or after a pancreatic resection at hospital A versus hospital B?  That's what's coming, Binder says.

"This is such powerful data," she says. "We're saying, 'this is your chance of survival if you go to this hospital and have this procedure. That's as raw edged as you can get in terms of transparency."

Take esophageal resection in Massachusetts: At Brigham and Women's Hospital, patients have a 3.29% odds of dying whereas at North Shore Medical Center Salem Hospital, it's 9.78%.

And for pancreatic resection in New Jersey: At John F. Kennedy Medical Center in Edison, patients have an 10.61%, chance of dying, compared with 3.85% at Morristown Memorial.

In fact, the variation among all the hospitals reporting resection survival scores is huge, she says. For esophageal resection over the last two years, the very best hospitals a patient has a 2.9% chance of mortality while at the worst hospitals, the odds are 12.1%. For pancreatic resection, no hospitals are in the best category, but the worst hospitals have death rates at 19% and 21%.

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2 comments on "Surgical Survival Predictors May Be Next Big Quality Metric"

John Rosenstock (5/24/2011 at 9:32 AM)
I would include gastric bypass surgery in the list as the mortaility rates can be very high at some hospitals.

Catherine Smith (5/20/2011 at 4:17 PM)
Healthcare transparency is a good idea in an ideal world. I am grateful to be able to look at publicly reported data and be able to determine what facility has the better outcomes, morbidity, and mortality rates in order to promote positive patient outcomes and consumer choice.However, the idea that the consumer actually has the ability to choose a top 10 percentile hospital is not reality. The reality is...the insurance carrier dictates what provider you choose. If the top 10 percentile facility is not in the insurance network then there is no choice. Unless a person is indigent, on Medicare, or independently wealthy.




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