Faculty Collaboration Database

Evaluating popular media and internet-based hospital quality ratings for cancer surgery. Arch Surg 2011 May;146(5):600-4

Date

05/18/2011

Pubmed ID

21576612

DOI

10.1001/archsurg.2011.119

Scopus ID

2-s2.0-79956015832 (requires institutional sign-in at Scopus site)   20 Citations

Abstract

OBJECTIVE: We sought to determine whether "best hospitals," as defined by the US News & World Report or HealthGrades, have lower mortality rates than all other American hospitals for cancer surgery.

DESIGN: Retrospective cross-sectional study.

SETTING: Medicare database (2005-2006).

PATIENTS: All patients with a diagnosis of malignancy who underwent pancreatectomy, esophagectomy, and colectomy (n = 82,724).

MAIN OUTCOMES MEASURES: Risk-adjusted mortality rates at best hospitals according to both the US News & World Report and HealthGrades, was compared with all other US hospitals, adjusting for differences in patient factors and surgical acuity. Risk-adjusted mortality rates between best hospitals and all other hospitals was compared after controlling for differences in hospital volume.

RESULTS: Risk-adjusted mortality was significantly lower in US News & World Report best hospitals for all 3 procedures: pancreatectomy (odds ratio [OR], 0.42; 95% confidence interval [CI], 0.30-0.58), esophagectomy (OR, 0.48; 95% CI, 0.37-0.62), and colectomy (OR, 0.69; 95% CI, 0.55-0.86). Risk-adjusted mortality was significantly lower in HealthGrades best hospitals for colectomy (OR, 0.79; 95% CI, 0.65-0.95). However, after accounting for hospital volume, risk-adjusted mortality was only significantly lower at the US News & World Report best hospitals for colectomy (OR, 0.79; 95% CI, 0.62-0.99) and was not significantly lower at HealthGrades best hospitals for any of the 3 oncologic procedures.

CONCLUSIONS: Publicly marketed hospital rating systems of surgical quality such as the US News & World Report "America's Best Hospitals" and HealthGrades "Best Hospitals" may identify high-quality hospitals for some oncologic surgeries. However, these ratings fail to identify other high-volume hospitals of equal quality.

Author List

Osborne NH, Ghaferi AA, Nicholas LH, Dimick JB, Mph M

Author

Amir Ghaferi MD President, Phys Enterprise & SAD Clinical Affairs in the Medical College Physicians Administration department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Cancer Care Facilities
Colectomy
Colonic Neoplasms
Confidence Intervals
Cross-Sectional Studies
Esophageal Neoplasms
Esophagectomy
Female
Health Care Surveys
Health Services Research
Hospital Mortality
Humans
Male
Medicare
Middle Aged
Newspapers as Topic
Odds Ratio
Pancreatectomy
Pancreatic Neoplasms
Public Opinion
Quality Indicators, Health Care
Quality of Health Care
Retrospective Studies
Risk Adjustment
United States