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abstract / editorial
Abstract
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons
Background:
Hospital-level measures of patient satisfaction and quality are now
reported publically by the Centers for Medicare and Medicaid
Services. There are limited metrics specific to
cancer patients. We examined whether publically reported hospital
satisfaction
and quality data were associated with surgical
oncologic outcomes.
Methods: The
Nationwide Inpatient Sample was utilized to identify patients with solid
tumors who underwent surgical resection in 2009
and 2010. The hospitals were linked to Hospital
Compare, which collects data on patient satisfaction, perioperative
quality,
and 30-day mortality for medical conditions
(pneumonia, myocardial infarction [MI], and congestive heart failure
[CHF]). The
risk-adjusted hospital-level rates of morbidity
and mortality were calculated for each hospital and the means compared
between
the highest and lowest performing hospital
quartiles and reported as absolute reduction in risk (ARR), the
difference in risk
of the outcome between the two groups. All
statistical tests were two-sided.
Results: A total of
63197 patients treated at 448 hospitals were identified. For patients at
high vs low performing hospitals based
on Hospital Consumer Assessment of Healthcare
Providers and Systems scores, the ARR in perioperative morbidity was
3.1% (blogger note: see abstract for stats -abbreviated for easy reading). Similarly, the ARR for mortality based on the same measure was -0.4% . High performance on perioperative quality measures resulted in an ARR of 0% to 2.2% for perioperative morbidity . Similarly, there was no statistically significant
association between hospital-level mortality rates for
MI , heart
failure or pneumonia and complications for
oncologic surgery patients.
Conclusion: Currently available measures of patient satisfaction and quality are poor predictors of outcomes for cancer patients undergoing
surgery. Specific metrics for long-term oncologic outcomes and quality are needed.
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