Patient Evaluation of Quality in GI Cancer Surgery

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Patient-reported quality measures, collected from those who underwent surgery for GI cancer, offered clinicians valuable insight into care management.
Patient-reported quality measures, collected from those who underwent surgery for GI cancer, offered clinicians valuable insight into care management.

An observational study showed that patient-reported experiences, in addition to surgical outcomes, can produce important insights into the quality of gastrointestinal cancer surgery offered at a hospital.1 The findings were published online October 29, 2018, in the Journal of Gastrointestinal Surgery.

The goal of the study was to characterize hospitals and patients based on 2 axes of quality: surgical outcomes and patient-reported experiences. By way of the American College of Surgeons' National Surgical Quality Improvement Program registry, researchers profiled hospitals based on risk-adjusted surgical complications for patients with gastrointestinal cancer who underwent colectomy, esophagectomy, hepatectomy, pancreatectomy, or proctectomy between January 1, 2015, and December 31, 2016. The Hospital Consumer Assessment of Healthcare Providers and Systems survey was also used to profile hospitals.

A total of 60,526 patients from 530 hospitals were identified and included in the analysis. Hospitals that were the highest-performing institutions were more likely to be National Cancer Institute-designated cancer centers (29.0% vs 4.2%, P = .002), and typically treated a smaller proportion of patients on Medicaid compared with the lowest-performing hospitals (0.14 vs 0.23, P < .001). A higher proportion of patients who underwent surgical operations at the lowest-performing hospitals compared with the best performing clinics were black (17.2% vs 8.4%, respectively, P < .001), Hispanic (8.3% vs 3.5%, respectively, P < 0.001), functionally dependent (3.8% vs 0.9%, respectively. P < 0.001), and not admitted from home (4.4% vs 2.4%, respectively, P < .001) compared to patients at the highest-performing hospitals.

“In conclusion, the patient-centeredness of traditional quality metrics that use surgical outcomes to assess hospital performance could be improved by simultaneously considering patient-reported experiences,” the study authors wrote.

Reference

  1. Liu JB, Pusic AL, Hall BL, Glasgow RE, Ko CY, and Temple LK. Combining surgical outcomes and patient experiences to evaluate hospital gastrointestinal cancer surgery quality [published online October 29, 2018]. J Gastrointest Surg. doi: 10.1007/s11605-018-4015-3

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