A new report from the Leapfrog Group indicates that survival rates for high-risk surgeries differ from hospital to hospital.
To reach this conclusion, Leapfrog Group used 2013 data from 1,500 hospitals on four risky surgeries, including number of procedures and patient deaths. These numbers were then adjusted to come up with a “predicted survival” rate for each.
The procedures looked at included aortic valve replacements (AVR), abdominal aortic aneurysm (AA) repairs, espohagectomy, and pancreatectomy.
The greatest variance in outcomes occurred with pancreatectomy, as the predicted survival rate varied from 100 percent to 81 percent between high- and low-performing hospitals, the report found. AVR procedures had the lowest survival rate variance, ranging between 97 and 92 percent survival rates.
More specific findings for each surgery are as follows:
- For replacing the heart's aortic valve (AVR), survival ranged from 92 percent to 97 percent with only 95 of 544 hospitals hitting 95.6 percent.
- For repairs of abdominal aortic aneurysm (AAA), survival ranged from 86 percent to 99 percent with 268 of 792 hospitals meeting the benchmark of 97.3 percent.
- For esophagectomy (removing all or part of the esophagus), expected survival ranged from 88 percent to 98 percent. Only 182 of 535 hospitals had rates of at least 91.7 percent.
- For pancreatectomy (removing all or part of the pancreas, usually to treat cancer), predicted survival rates ranged from 81 percent to 100 percent. Of 487 hospitals reporting data, 203 had rates of at least 91.3 percent, which Leapfrog Group chose as the benchmark for quality.
The study didn't analyze which kinds of hospitals - nonprofit or for-profit, in one region or another excelled, but in general those that performed more procedures did best. Four hospitals that were found to perfect all four surgeries were Brigham and Women’s Hospital, Mayo Clinic, Hoag Memorial, and Morristown Medical.
This study is particularly interesting as hospitals face a continued pressure to do better in terms of quality, however, now they should also be encouraged to continue to work better for consistent surgical outcomes.
Definitive Healthcare’s hospital database tracks quality metrics, including Serious Complication Measures, as reported to the Agency for Healthcare Research and Quality. This includes data on how hospitals performed with treatable complications after surgery. Currently, Definitive Healthcare tracks 185 hospitals that scored in the lowest percentile (0-10%) for this measure.