All that data the government uses to judge the quality of hospitals? It may not mean anything when it comes to ascertaining a patient's risk of post-surgical infection. According to a study published in the Journal of the American Medical Association this week--and based on public hospital comparison data from the Department of Health and Human Services--data reported to the government doesn't correlate to surgical patient risk.
Researchers from Case Western Reserve University School of Medicine looked at more than 400,000 patients from 398 hospitals nationwide and examined the relationship between reported adherence to six infection prevention Surgical Care Improvement Project (SCIP) measures and the probability of patient post-operative infection.
Lead author Jonah Stulberg, MD, PhD, MPH, found that using only a single SCIP measure--as Medicare currently requires--didn't make much difference in gauging patient risk. Using more than one SCIP measure, however, proved more accurate at predicting post-operative infection, and ultimately led to a 15 percent decline in risk.
The new healthcare reform law eventually will tie Medicare reimbursement to adherence to SCIP measures. Stulberg and his co-authors recommend SCIP require multiple measures be performed and recorded at every single patient visit in order to more accurately predict whether patients are at risk for postoperative infection.
SCIP is a national quality partnership dedicated to reducing the rate of surgical complications. The six measures covered by this study include:
- Patients who received antibiotics within one hour prior to surgery.
- Patients who received the appropriate antibiotic for their specific procedure.
- Patients whose antibiotics were discontinued within 24 hours after surgery.
- Cardiac surgery patients with a controlled postoperative blood glucose level.
- Surgery patients with appropriate surgical site hair removal.
- Colorectal surgery patients with immediate postoperative normothermia.