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Surgical death rates are not a reliable measure of hospital quality
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Bruce, J. (Julie) (2005) Surgical death rates are not a reliable measure of hospital quality. Evidence-based Healthcare and Public Health, 9 (1). pp. 20-22. doi:10.1016/j.ehbc.2004.11.011
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Official URL: http://dx.doi.org/10.1016/j.ehbc.2004.11.011
Abstract
Question: Are enough surgical procedures performed to use surgical mortality rates as a reliable measure of hospital quality? Study design : Cohort study Main results: In a 3-year observation perio d, 90% of hospitals performing coronary artery bypass graft (CABG) surgery exceeded the minimum number of cases needed to reliably detect poor performance (see Results table). However, only a small proportion of hospitals exceeded the minimum number of cases for craniotomy, paediatric heart surgery, repair of abdominal anuerysum, pancreatic resection, oesophageal resection and hip replacement. Altering the definition of poor performance from twice to 1.5 times the national average death rate for each procedure significantly reduced the number of hospitals that exceeded the minimum number of cases (data not shown). When the observation period was increased to 5 years, CABG surgery was still the only procedure that exceeded the minimum number of cases (data not shown). Authors' conclusions: Mortality from CABG surgery may be a usef ul measure of hospital quality. Craniotomy, paediatric heart surgery, repair of abdominal aneurysm, pancreatic resection, oesophageal resection or hip replacement are not performed frequently enough and an alternative quality indicator for these procedures should be found. © 2005 Elsevier Ltd. All rights reserved.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
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| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| Journal or Publication Title: | Evidence-based Healthcare and Public Health | ||||||
| Publisher: | Elsevier | ||||||
| ISSN: | 1744-2249 | ||||||
| Official Date: | February 2005 | ||||||
| Dates: |
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| Volume: | 9 | ||||||
| Number: | 1 | ||||||
| Page Range: | pp. 20-22 | ||||||
| DOI: | 10.1016/j.ehbc.2004.11.011 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||
| Funder: | U.S Department of Veterans Affairs, Agency for Healthcare Research and Quality |
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