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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 ISSN 1744-2249.

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Official URL: http://dx.doi.org/10.1016/j.ehbc.2004.11.011

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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
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title: Evidence-based Healthcare and Public Health
Publisher: Elsevier
ISSN: 1744-2249
Official Date: February 2005
Dates:
DateEvent
February 2005Published
1 February 2005Accepted
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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