Report cards don't influence surgical outcomes or reduce complications, studies find

Two studies published in JAMA show no connection between participating in the American College of Surgeons National Surgical Quality Improvement Program and improved surgical outcomes, complications, readmissions or risk of death.

Hospitals that participate in the ACS NSQIP record data about operations and send it to a central database. Then, the ACS looks at the data and shares quality reports, allowing participating hospitals to benchmark their performance against other organizations. Hospitals are then encouraged to focus on improving in areas where they fall behind others.

One study involved looking at ACS NSQIP participation as well as surgical outcomes and payments among Medicare patients. Researchers from the University of Michigan in Ann Arbor examined national Medicare data from patients undergoing general and vascular surgery at 263 hospitals participating in the program and 526 that were not.

They found no difference in improved outcomes between participating and non-participating hospitals over three years — while participating hospitals did see some better outcomes, so did the control hospitals, and the improvements were very similar.

"Enrollment in a national surgical quality reporting program was not associated with improved outcomes…among Medicare patients," the authors wrote. "Feedback of outcomes alone may not be sufficient to improve surgical outcomes."

In another study, Mayo Clinic Arizona researchers examined rates of complications, serious complications and death during an elective general or vascular surgery in ACS NSQIP hospitals and those that did not participate, using data from the University HealthSystem Consortium.

Postoperative complications, serious complications and death decreased in both NSQIP hospitals and those that did not participate in the program, the researchers found.

The authors of this study agreed with the former, writing "Among hospitals providing care to patients undergoing general and vascular surgical procedures, our findings suggest that a surgical outcomes reporting system does not provide a clear mechanism for quality improvement."

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