Using postoperative blood clotting as a hospital quality measure may be inaccurate, as such rates may be tainted by surveillance bias, according to an article published in the Journal of the American Medical Association.
Currently the Agency for Healthcare Research and Quality has a risk-adjusted postoperative venous thromboembolism measure that is used in many quality improvement programs and public reporting initiatives. Venous thromboemblisms, or blood clots, are a common postoperative complication.
The article's authors examined Medicare claims data from Hospital Compare and the American Hospital Association for patients undergoing at least one of 11 major operations used to calculate VTE rates and VTE imaging rates.
They found that higher rates of imaging, used for VRE prevention, correlated with higher VRE rates.
The study authors note that using VTE rates as a measure of hospital quality is paradoxical; the more clinicians search for VTEs, the more they will find. Finding more VTEs causes worse performance in quality metrics incorporating VTE rates, though if VTEs are found they may be safely dealt with.
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