The American Journal of Surgery
Volume 198, Issue 5, Supplement , Pages S28-S35 , November 2009

Adjusted or unadjusted outcomes

Presented at the NSQIP 15th Anniversary Meeting and Festschrift in memory of Shukri F. Khuri, M.D.

  • Aaron S. Fink, M.D.

      Affiliations

    • Corresponding Author InformationCorresponding author. Tel.: +1 404 728 7621; fax: +1 404 327 4971

Received 2 June 2009 ,Revised 23 July 2009

References 

  1. Neuhauser DE, Amory Codman MD. and end results of medical care. Int J Technol Assess Health Care. 1990;6:307–325
  2. Morrato EH, Dillon P, Ziegler M. Surgical outcomes research: a progression from performance audits, to assessment of administrative databases, to prospective risk-adjusted analysis—how far have we come?. Curr Opin Pediatr. 2008;20:320–325
  3. Wright JE. The history of surgical audit. J Qual Clin Pract. 1995;15:81–88
  4. Myers RS. A new concept of the medical audit. Hospitals. 1957;31:49–51
  5. Strauch GO. Problem-oriented surgical audit in the community hospital (A concept in evolution). Am J Surg. 1975;129:401–406
  6. Donati A, Ruzzi M, Adrario E, et al. A new and feasible model for predicting operative risk. Br J Anaesth. 2004;93:393–399
  7. Andrus CH, Daly JL. Evaluation of surgical services in a large university-affiliated VA Hospital: use of an in-house-generated quality assurance database. South Med J. 1991;84:1447–1450
  8. Miller DC, Filson CP, Wallner LP, et al. Comparing performance of Morbidity and Mortality Conference and National Surgical Quality Improvement Program for detection of complications after urologic surgery. Urology. 2006;68:931–937
  9. Hutter MM, Rowell KS, Devaney LA, et al. Identification of surgical complications and deaths: an assessment of the traditional surgical morbidity and mortality conference compared with the American College of Surgeons-National Surgical Quality Improvement Program. J Am Coll Surg. 2006;203:618–624
  10. Iezzoni LI. An introduction to risk adjustment. Am J Med Qual. 1996;11:S8–S11
  11. Iezzoni LI. The risks of risk adjustment. J Am Med Assoc. 1997;278:1600–1607
  12. Iezzoni LI. Assessing quality using administrative data. Ann Intern Med. 1997;127:666–674
  13. Iezzoni LI, Ash AS, Shwartz M, et al. Predicting who dies depends on how severity is measured: implications for evaluating patient outcomes. Ann Intern Med. 1995;123:763–770
  14. Atherly A, Fink AS, Campbell DC, et al. Evaluating alternative risk adjustment strategies for surgery. Am J Surg. 2004;188:566–570
  15. Stremple JF, Bross DS, Davis CL, et al. Comparison of postoperative mortality in VA and private hospitals. Ann Surg. 1993;217:277–285
  16. McClure W. Competition and the pursuit of quality: a conversation with Walter McClure (Interview by John K Iglehart). Health Aff Millwood. 1988;7:79–90
  17. Rosenthal GE, Harper DL. Cleveland health quality choice: a model for collaborative community-based outcomes assessment. Joint Commun J Qual Improv. 1994;20:425–442
  18. Daley J, Forbes MG, Young GJ, et al. Validating risk-adjusted surgical outcomes: site visit assessment of process and structure (National VA Surgical Risk Study). J Am Coll Surg. 1997;185:341–351
  19. Daley J, Khuri SF, Henderson W, et al. Risk adjustment of the postoperative morbidity rate for the comparative assessment of the quality of surgical care: results of the National Veterans Affairs Surgical Risk Study. J Am Coll Surg. 1997;185:328–340
  20. Khuri SF, Daley J, Henderson W, et al. The National Veterans Administration Surgical Risk Study: risk adjustment for the comparative assessment of the quality of surgical care. J Am Coll Surg. 1995;180:519–531
  21. Khuri SF, Daley J, Henderson W, et al. Risk adjustment of the postoperative mortality rate for the comparative assessment of the quality of surgical care: results of the National Veterans Affairs Surgical Risk Study. J Am Coll Surg. 1997;185:315–327
  22. O'Connor GT, Plume SK, Olmstead EM, et al. A regional intervention to improve the hospital mortality associated with coronary artery bypass graft surgery (The Northern New England Cardiovascular Disease Study Group). J Am Med Assoc. 1996;275:841–846
  23. Khuri SF, Daley J, Henderson W, et al. The Department of Veterans Affairs' NSQIP: the first national, validated, outcome-based, risk-adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care (National VA Surgical Quality Improvement Program). Ann Surg. 1998;228:491–507
  24. Dubois RW. Inherent limitations of hospital death rates to assess quality. Int J Technol Assess Health Care. 1990;6:220–228
  25. Rosen HM, Green BA. The HCFA excess mortality lists: a methodological critique. Hosp Health Serv Adm. 1987;32:119–127
  26. US General Accounting Office, Health Education and Health Services Division. Employers and Individual Consumers Want Additional Information on Quality. United States General Accounting Office; 1995;
  27. Freeman JL, Fetter RB, Park H, et al. Diagnosis-related group refinement with diagnosis- and procedure-specific comorbidities and complications. Med Care. 1995;33:806–827
  28. Birkmeyer JD, Dimick JB. Potential benefits of the new leapfrog standards: effect of process and outcomes measures. Surgery. 2004;135:569–575
  29. Birkmeyer JD, Siewers AE, Finlayson EV, et al. Hospital volume and surgical mortality in the United States. N Engl J Med. 2002;346:1128–1137
  30. Betensky RA, Christian CK, Gustafson ML, et al. Hospital volume versus outcome: an unusual example of bivariate association. Biometrics. 2006;62:598–604
  31. Christian CK, Gustafson ML, Betensky RA, et al. The leapfrog volume criteria may fall short in identifying high-quality surgical centers. Ann Surg. 2003;238:447–455
  32. Christian CK, Gustafson ML, Betensky RA, et al. The volume-outcome relationship: don't believe everything you see. World J Surg. 2005;29:1241–1244
  33. Phillips KA, Luft HS. The policy implications of using hospital and physician volumes as “indicators” of quality of care in a changing health care environment. Int J Qual Health Care. 1997;9:341–348
  34. Khuri SF, Daley J, Henderson W, et al. Relation of surgical volume to outcome in eight common operations: results from the VA National Surgical Quality Improvement Program. Ann Surg. 1999;230:414–429
  35. Khuri SF, Henderson WG. The case against volume as a measure of quality of surgical care. World J Surg. 2005;29:1222–1229
  36. Best WR, Khuri SF, Phelan M, et al. Identifying patient preoperative risk factors and postoperative adverse events in administrative databases: results from the Department of Veterans Affairs National Surgical Quality Improvement Program. J Am Coll Surg. 2002;194:257–266
  37. Birim O, Zuydendorp HM, Maat AP, et al. Lung resection for non-small-cell lung cancer in patients older than 70: mortality, morbidity, and late survival compared with the general population. Ann Thorac Surg. 2003;76:1796–1801
  38. Guzzo TJ, Allaf ME, Pierorazio PM, et al. Perioperative outcomes of elderly patients undergoing laparoscopic renal procedures. Urology. 2009;73:572–576
  39. Koppie TM, Serio AM, Vickers AJ, et al. Age-adjusted Charlson Comorbidity Score is associated with treatment decisions and clinical outcomes for patients undergoing radical cystectomy for bladder cancer. Cancer. 2008;112:2384–2392
  40. Tan KY, Kawamura Y, Mizokami K, et al. Colorectal surgery in octogenarian patients—outcomes and predictors of morbidity. Int J Colorectal Dis. 2009;24:185–189
  41. Timaran CH, Rosero EB, Smith ST, et al. Trends and outcomes of concurrent carotid revascularization and coronary bypass. J Vasc Surg. 2008;48:355–360
  42. Rieker RJ, Hammer E, Eisele R, et al. The impact of comorbidity on the overall survival and the cause of death in patients after colorectal cancer resection. Langenbecks Arch Surg. 2002;387:72–76
  43. Ash AS, Zhao Y, Ellis RP, et al. Finding future high-cost cases: comparing prior cost versus diagnosis-based methods. Health Serv Res. 2001;36:194–206
  44. Fink AS, Campbell DA, Mentzer RM, et al. The National Surgical Quality Improvement Program in non-Veterans Administration hospitals: initial demonstration of feasibility. Ann Surg. 2002;236:344–353
  45. Schroeder RA, Marroquin CE, Bute BP, et al. Predictive indices of morbidity and mortality after liver resection. Ann Surg. 2006;243:373–379
  46. Livingston EH. Development of bariatric surgery-specific risk assessment tool. Surg Obes Relat Dis. 2007;3:14–20
  47. Steinberg SM, Popa MR, Michalek JA, et al. Comparison of risk adjustment methodologies in surgical quality improvement. Surgery. 2008;144:662–667
  48. Pine M, Jordan HS, Elixhauser A, et al. Enhancement of claims data to improve risk adjustment of hospital mortality. J Am Med Assoc. 2007;297:71–76
  49. Cardinal Health (Atlas Outcomes System). www.mediqual.com/products/atlas.aspAccessed Sept 20, 2009
  50. Hall BL, Hirbe M, Waterman B, et al. Comparison of mortality risk adjustment using a clinical data algorithm (American College of Surgeons National Surgical Quality Improvement Program) and an administrative data algorithm (Solucient) at the case level within a single institution. J Am Coll Surg. 2007;205:767–777
  51. Statement of JD Daigh Jr., M.D. VA credentialing and privileging: A patient safety issue. Subcommittee on Oversight and Investigations, Committee on Veterans' Affairs, United States House of Representatives January 29, 2008;
  52. Committee on Enhanced Federal Healthcare Quality. Leadership by Example: Coordinating Government Roles in Improving Health Care Quality (Institute of Medicine). Washington, DC: National Academies Press; 2002;
  53. Schilling PL, Dimick JB, Birkmeyer JD. Prioritizing quality improvement in general surgery. J Am Coll Surg. 2008;207:698–704
  54. Birkmeyer JD, Dimick JB, Birkmeyer NJ. Measuring the quality of surgical care: structure, process, or outcomes?. J Am Coll Surg. 2004;198:626–632
  55. Khuri SF, The N. A new frontier in surgery. Surgery. 2005;138:837–843

PII: S0002-9610(09)00462-0

doi: 10.1016/j.amjsurg.2009.08.001

The American Journal of Surgery
Volume 198, Issue 5, Supplement , Pages S28-S35 , November 2009

Article Tools

* Image Usage & Resolution