Association of Hospital Participation in a Quality Reporting Program With Surgical Outcomes and Expenditures for Medicare Beneficiaries

Outcomes are Worse in US Patients Undergoing Surgery on Weekends Compared With Weekdays

“…16,17 We examined the association between surgical outcomes and weekend surgery using logistic regression. We controlled for patient demographics (age, sex, and race), payer status, procedure type, transfer status, and comorbidities.…”

Response to “Does Participation in the ACS-NSQIP Improve Outcomes?”

“…Osborne and Etzioni would hold that their own work demonstrates that a control group methodology is available. 3,4 On the basis of our previous criticisms, we do not share the sentiment that those studies are compelling on the issue of NSQIP's value.…”

“…3,4 However, those studies relied on administrative data (Medicare Analysis Provider and Review files and University HealthSystem Consortium; CMS and UHC, respectively) and administrative data can be misleading. In another Annals of Surgery article, only 26% of hospital performance outliers using CMS administrative data were also outliers using NSQIP data, and only 16% of NSQIP outliers were CMS outliers.…”

Understanding Quality Issues in Your Surgical Department: Comparing the ACS NSQIP With Traditional Morbidity and Mortality Conferences in a Canadian Academic Hospital

“…A recent pilot study reported that integration of outcomes data (customized reports of patient outcomes) into surgical education is acceptable among residency programs and feasible to implement. 16 Although 2 recent large-scale studies did not demonstrate statistically significant improvements in the incidence of complications in NSQIP-enrolled hospitals when compared with controls, 9,10 it is clear that participation in the ACS NSQIP can contribute to improved patient safety and provide a platform for quality improvement. For instance, participating hospitals have shown reduced rates of pneumonia 17 and urinary tract infections.…”

“…In fact, 2 recent studies, tracking more than a million patients, reported no statistically relevant difference in M&M rates in NSQIP-enrolled hospitals when compared with matched controls. 9,10 The authors speculate that participation in the ACS NSQIP is not in itself sufficient to decrease adverse events, but rather that the hospitals must develop in-house programs to act on the data that the NSQIP captures to maximize its use. 11 The objective of this study was to compare complications identified by the ACS NSQIP with those captured in M&M conferences at an academic hospital in Toronto, Ontario, Canada.…”