Weak Relationship Between Surgical Oncologic Perioperative Morbidity and Publicly Reported Hospital Quality and Satisfaction Measures
In a study reported in the Journal of the National Cancer Institute, Wright et al found a weak relationship between measures of patient satisfaction and quality and surgical oncologic perioperative outcomes at the hospital level.
Study Details
In the study, the Nationwide Inpatient Sample was used to identify patients with solid tumors who underwent surgical resection in 2009 and 2010. Hospitals were linked to Hospital Compare, which collects data on patient satisfaction, perioperative quality, and 30-day mortality for medical conditions. Patient satisfaction was based on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. Perioperative quality measures were assessed by Surgical Care Improvement Project (SCIP) data.
Small Improvements in Risk
The study included 63,197 patients treated at 448 hospitals. For patients at high (75th percentile) vs low (25th percentile) performing hospitals based on HCAHPS scores, the risk-adjusted absolute risk reduction in perioperative morbidity was 3.1% (95% confidence interval [CI] = 0.4%–5.7%, P = .02), and the absolute risk reduction for 30-day mortality was −0.4% (95% CI = −1.5% to 0.6%, P = .40).
High performance on SCIP perioperative quality measures (compliance with three antibiotic measures and two venous thromboembolism prophylaxis measures) was associated with absolute risk reductions of 0% to 2.2% for perioperative morbidity (all P > .05). There was no significant association between perioperative complications for oncologic surgical patients according to high- vs low-mortality hospitals for myocardial infarction (absolute risk reduction = 0.7%, 95% CI = −1.0% to 2.5%), heart failure (absolute risk reduction = 1.0%, 95% CI = −0.6% to 2.7%), or pneumonia (absolute risk reduction = 1.6%, 95% CI = −0.3% to 3.5%).
The investigators concluded: “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.”
Jason D. Wright, MD, of Columbia University College of Physicians and Surgeons, is the corresponding author of the Journal of the National Cancer Institute article.
The study was supported by grants from the National Cancer Institute. The study authors reported no potential conflicts of interest.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
