Makary is emphatic that national standards requiring hospital reporting are the only way to achieve consistency for fair comparison and for meaningful efforts toward improvement.
"Our study highlights the need for the Federal Government to set the rules for how hospitals define, monitor and report SSIs," he adds.
"Though SSI process measures have received tremendous attention from CMS, the public, and the media, studies have failed to demonstrate that adherence to these measures reduce SSIs...In fact, focusing on process measures rather than outcomes may divert important resources that could improve quality," he wrote.
Emphasizing that he was not commenting on or responding to Makary's report per se, Dan Pollock, MD, CDC Surveillance Branch Chief for the Division of Healthcare Quality Promotion, explained that over time, the agencies intend that the types of procedures will be expanded for payment. "But colon (surgery) is one of the worst for infections, and we think it's really important. And abdominal hysterectomies are frequently performed." He added, "this is just a start."
Makary, a well-known advocate of expanded transparency in healthcare, is the author of an upcoming book entitled, "Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care." He says public display of provider outcomes, by name as well as by facility, has the greatest impact on improving quality of care and points to New York state as a prime example.