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health_care [2016/12/06 13:27]
127.0.0.1 external edit
health_care [2017/03/20 12:35] (current)
administrador
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 Today’s [[health care]] environment demands more than ever of surgeons and the hospitals they work in. Payors, including [[Medicare]],​ increasingly refuse to pay for treating [[complication]]s deemed preventable,​ such as [[surgical site infection]]s. Today’s [[health care]] environment demands more than ever of surgeons and the hospitals they work in. Payors, including [[Medicare]],​ increasingly refuse to pay for treating [[complication]]s deemed preventable,​ such as [[surgical site infection]]s.
 +----
 +The accuracy of public reporting in health care, especially from private vendors, remains an issue of debate.
 +
 +Bekelis et al. performed a cohort study involving physicians performing [[posterior lumbar fusion]]s between 2009 and 2013 who were registered in the Statewide Planning and Research Cooperative System database. This cohort was merged with publicly available data over the same time period from ProPublica, a private company. Mixed-effects multivariable regression models were used to investigate the association of publicly available complication rates with the rate of discharge to a rehabilitation facility, length of stay, mortality, and hospitalization charges for the same surgeons. ​
 +
 +During the selected study period, there were 8,457 patients in New York State who underwent posterior lumbar fusion performed by the 56 surgeons represented in the ProPublica Surgeon Scorecard over the same time period. Using a mixed-effects multivariable regression model, the authors demonstrated that publicly reported physician-level complication rates were not associated with the rate of discharge to a rehabilitation facility (OR 0.97, 95% CI 0.72-1.31), length of stay (adjusted difference -0.1, 95% CI -0.5 to 0.2), mortality (OR 0.87, 95% CI 0.49-1.55), and hospitalization charges (adjusted difference $18,735, 95% CI -$59,177 to $96,647). Similarly, no association was observed when utilizing propensity score-adjusted models, and when restricting the cohort to a predefined subgroup of Medicare patients. ​
 +
 +After merging a comprehensive all-payer posterior lumbar fusion cohort in New York State with data from the ProPublica Surgeon Scorecard over the same time period, the authors observed no association of publicly available physician complication rates with objective outcomes
 +((Bekelis K, Missios S, Coy S, Johnson JN. Does the ranking of surgeons in a
 +publicly available online platform correlate with objective outcomes? J
 +Neurosurg. 2017 Mar 17:1-7. doi: 10.3171/​2016.8.JNS16583.test. [Epub ahead of
 +print] PubMed PMID: 28306419.
 +)).
health_care.txt · Last modified: 2017/03/20 12:35 by administrador