Surgical Survival Predictors May Be Next Big Quality Metric
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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