Risk-adjusted surgical outcomes
Measures of risk-adjusted outcome are particularly suited for the assessment of the quality of surgical care. The reliability of measures of quality that use surgical outcomes is enhanced by prospective data acquisition and should be adjusted for the preoperative severity of illness. Such measures s...
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| Veröffentlicht in: | Annual review of medicine 2001-01, Vol.52 (1), p.275-287 |
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| creator | DALEY, Jennifer HENDERSON, William G KHURI, Shukri F |
| description | Measures of risk-adjusted outcome are particularly suited for the assessment of the quality of surgical care. The reliability of measures of quality that use surgical outcomes is enhanced by prospective data acquisition and should be adjusted for the preoperative severity of illness. Such measures should be based only on reliable and validated data, and they should apply state-of-the-art analytical methods. The risk-adjusted postoperative mortality rate is useful as a quality measure only in specialties and operations expected to have a high rate of postoperative deaths. Risk-adjusted complications are more common but are limited as a comparative measure of quality by a lack of uniform definitions and data collection mechanisms. In specialties in which the expected postoperative mortality is low, risk-adjusted functional outcomes are promising measures for the assessment of the quality of surgical care. Measures of cost and patient satisfaction should also be incorporated in systems designed to measure the quality and cost-effectiveness of surgical care. |
| doi_str_mv | 10.1146/annurev.med.52.1.275 |
| format | Article |
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The reliability of measures of quality that use surgical outcomes is enhanced by prospective data acquisition and should be adjusted for the preoperative severity of illness. Such measures should be based only on reliable and validated data, and they should apply state-of-the-art analytical methods. The risk-adjusted postoperative mortality rate is useful as a quality measure only in specialties and operations expected to have a high rate of postoperative deaths. Risk-adjusted complications are more common but are limited as a comparative measure of quality by a lack of uniform definitions and data collection mechanisms. In specialties in which the expected postoperative mortality is low, risk-adjusted functional outcomes are promising measures for the assessment of the quality of surgical care. Measures of cost and patient satisfaction should also be incorporated in systems designed to measure the quality and cost-effectiveness of surgical care.</description><identifier>ISSN: 0066-4219</identifier><identifier>EISSN: 1545-326X</identifier><identifier>DOI: 10.1146/annurev.med.52.1.275</identifier><identifier>PMID: 11160779</identifier><identifier>CODEN: ARMCAH</identifier><language>eng</language><publisher>Palo Alto, CA: Annual Reviews</publisher><subject>Activities of Daily Living ; Biological and medical sciences ; Cost-Benefit Analysis ; Data Collection - methods ; Data Interpretation, Statistical ; General aspects ; Hospital Mortality ; Hospitals, Veterans ; Humans ; Length of Stay - statistics & numerical data ; Medical sciences ; Miscellaneous ; Morbidity ; Patient Satisfaction ; Planification. Prevention (methods). Intervention. Evaluation ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Quality Indicators, Health Care ; Quality of Health Care ; Reproducibility of Results ; Risk Adjustment - methods ; Severity of Illness Index ; Surgery (general aspects). Transplantations, organ and tissue grafts. 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The reliability of measures of quality that use surgical outcomes is enhanced by prospective data acquisition and should be adjusted for the preoperative severity of illness. Such measures should be based only on reliable and validated data, and they should apply state-of-the-art analytical methods. The risk-adjusted postoperative mortality rate is useful as a quality measure only in specialties and operations expected to have a high rate of postoperative deaths. Risk-adjusted complications are more common but are limited as a comparative measure of quality by a lack of uniform definitions and data collection mechanisms. In specialties in which the expected postoperative mortality is low, risk-adjusted functional outcomes are promising measures for the assessment of the quality of surgical care. Measures of cost and patient satisfaction should also be incorporated in systems designed to measure the quality and cost-effectiveness of surgical care.</description><subject>Activities of Daily Living</subject><subject>Biological and medical sciences</subject><subject>Cost-Benefit Analysis</subject><subject>Data Collection - methods</subject><subject>Data Interpretation, Statistical</subject><subject>General aspects</subject><subject>Hospital Mortality</subject><subject>Hospitals, Veterans</subject><subject>Humans</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Medical sciences</subject><subject>Miscellaneous</subject><subject>Morbidity</subject><subject>Patient Satisfaction</subject><subject>Planification. Prevention (methods). Intervention. Evaluation</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Quality Indicators, Health Care</subject><subject>Quality of Health Care</subject><subject>Reproducibility of Results</subject><subject>Risk Adjustment - methods</subject><subject>Severity of Illness Index</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgical Procedures, Operative - adverse effects</subject><subject>Surgical Procedures, Operative - psychology</subject><subject>Surgical Procedures, Operative - standards</subject><subject>Survival Analysis</subject><subject>Total Quality Management - organization & administration</subject><subject>Treatment Outcome</subject><subject>United States - epidemiology</subject><subject>United States Department of Veterans Affairs</subject><issn>0066-4219</issn><issn>1545-326X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpdkEtLw0AUhQdRbK3-A9Gi4C5x7ryzlOILCoIouBsmk4mkpkmdyQj-e6c0dOHqLs53DpcPoXPAOQATt6bronc_-dpVOSc55ETyAzQFznhGifg4RFOMhcgYgWKCTkJYYYwLStUxmgCAwFIWU3T52oSvzFSrGAZXzUP0n4017byPg-3XLpyio9q0wZ2Nd4beH-7fFk_Z8uXxeXG3zCzlasgYLmshTCWkrZUzmFApRVnzqmZCcckLzABKCsSCcYYBFiUo6gypSqysc3SGbna7G99_RxcGvW6CdW1rOtfHoCXmiklGE3j1D1z10XfpN00IEYLLAhLEdpD1fQje1Xrjm7Xxvxqw3trToz2d7GlONOhkL9Uuxu1YboN9adSVgOsRMCFZqr3pbBP2XEEEKEL_AH4teSg</recordid><startdate>20010101</startdate><enddate>20010101</enddate><creator>DALEY, Jennifer</creator><creator>HENDERSON, William G</creator><creator>KHURI, Shukri F</creator><general>Annual Reviews</general><general>Annual Reviews, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7T5</scope><scope>7TO</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>MBDVC</scope><scope>P64</scope><scope>PADUT</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20010101</creationdate><title>Risk-adjusted surgical outcomes</title><author>DALEY, Jennifer ; HENDERSON, William G ; KHURI, Shukri F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c358t-40bf66ad67cf8ea023776bf5df46857590411b312c1aea4106b183ea2db08cee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Activities of Daily Living</topic><topic>Biological and medical sciences</topic><topic>Cost-Benefit Analysis</topic><topic>Data Collection - methods</topic><topic>Data Interpretation, Statistical</topic><topic>General aspects</topic><topic>Hospital Mortality</topic><topic>Hospitals, Veterans</topic><topic>Humans</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Medical sciences</topic><topic>Miscellaneous</topic><topic>Morbidity</topic><topic>Patient Satisfaction</topic><topic>Planification. Prevention (methods). Intervention. Evaluation</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Quality Indicators, Health Care</topic><topic>Quality of Health Care</topic><topic>Reproducibility of Results</topic><topic>Risk Adjustment - methods</topic><topic>Severity of Illness Index</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgical Procedures, Operative - adverse effects</topic><topic>Surgical Procedures, Operative - psychology</topic><topic>Surgical Procedures, Operative - standards</topic><topic>Survival Analysis</topic><topic>Total Quality Management - organization & administration</topic><topic>Treatment Outcome</topic><topic>United States - epidemiology</topic><topic>United States Department of Veterans Affairs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DALEY, Jennifer</creatorcontrib><creatorcontrib>HENDERSON, William G</creatorcontrib><creatorcontrib>KHURI, Shukri F</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Research Library China</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Annual review of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DALEY, Jennifer</au><au>HENDERSON, William G</au><au>KHURI, Shukri F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk-adjusted surgical outcomes</atitle><jtitle>Annual review of medicine</jtitle><addtitle>Annu Rev Med</addtitle><date>2001-01-01</date><risdate>2001</risdate><volume>52</volume><issue>1</issue><spage>275</spage><epage>287</epage><pages>275-287</pages><issn>0066-4219</issn><eissn>1545-326X</eissn><coden>ARMCAH</coden><abstract>Measures of risk-adjusted outcome are particularly suited for the assessment of the quality of surgical care. The reliability of measures of quality that use surgical outcomes is enhanced by prospective data acquisition and should be adjusted for the preoperative severity of illness. Such measures should be based only on reliable and validated data, and they should apply state-of-the-art analytical methods. The risk-adjusted postoperative mortality rate is useful as a quality measure only in specialties and operations expected to have a high rate of postoperative deaths. Risk-adjusted complications are more common but are limited as a comparative measure of quality by a lack of uniform definitions and data collection mechanisms. In specialties in which the expected postoperative mortality is low, risk-adjusted functional outcomes are promising measures for the assessment of the quality of surgical care. Measures of cost and patient satisfaction should also be incorporated in systems designed to measure the quality and cost-effectiveness of surgical care.</abstract><cop>Palo Alto, CA</cop><pub>Annual Reviews</pub><pmid>11160779</pmid><doi>10.1146/annurev.med.52.1.275</doi><tpages>13</tpages></addata></record> |
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| ispartof | Annual review of medicine, 2001-01, Vol.52 (1), p.275-287 |
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| language | eng |
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| source | Annual Reviews Complete A-Z List; MEDLINE |
| subjects | Activities of Daily Living Biological and medical sciences Cost-Benefit Analysis Data Collection - methods Data Interpretation, Statistical General aspects Hospital Mortality Hospitals, Veterans Humans Length of Stay - statistics & numerical data Medical sciences Miscellaneous Morbidity Patient Satisfaction Planification. Prevention (methods). Intervention. Evaluation Public health. Hygiene Public health. Hygiene-occupational medicine Quality Indicators, Health Care Quality of Health Care Reproducibility of Results Risk Adjustment - methods Severity of Illness Index Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgical Procedures, Operative - adverse effects Surgical Procedures, Operative - psychology Surgical Procedures, Operative - standards Survival Analysis Total Quality Management - organization & administration Treatment Outcome United States - epidemiology United States Department of Veterans Affairs |
| title | Risk-adjusted surgical outcomes |
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