Variation in Patient-reported Outcomes Across Hospitals Following Surgery
Bibliographic Data
| ID | 9103806 |
|---|---|
| Authors | Jennifer F Waljee (0000-0001-9878-5704, corresponding author), Amir A Ghaferi (0000-0001-8779-7726, corresponding author), Amir Ghaferi, Jonathan F Finks (0000-0002-7625-3472, corresponding author), Ruth Cassidy (0000-0002-7865-1132), Oliver Varban, Oliver A Varban (0000-0002-2860-3802, corresponding author), Arthur M Carlin, Arthur Carlin, Noelle E Carlozzi (0000-0003-0439-9429, University of Michigan), Noelle Carlozzi, Justin B Dimick (0000-0002-4796-6641, corresponding author), Justin Dimick |
| Year | 2015 |
| Volume | 53 |
| Issue | 11 |
| Pages | 960-966 |
| Publication date | 2015-11-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000000425 |
| PMID | 26465124 |
| OpenAlex | W2331620126 |
| Language | EN |
| Citations received | 1 |
| References cited | 40 |
BACKGROUND: Although there is growing interest in applying patient-reported outcomes (PROs) toward surgical quality, the extent to which PROs vary across hospitals following surgical procedures is unknown. OBJECTIVES: We examined variation in PROs, specifically health-related quality of life (HRQOL), across hospitals performing bariatric surgery. RESEARCH DESIGN: A retrospective cohort study. SUBJECTS: The Michigan Bariatric Surgery Collaborative is a statewide consortium of 39 hospitals performing laparoscopic gastric bypass, gastric banding, or sleeve gastrectomy (n=11,420 patients between 2008 and 2012). MEASURES: We examined generic and disease-specific HRQOL measured by the Health and Activities Limitations Index (HALex) and Bariatric Quality of Life index (BQL) preoperatively and at 1 year. We measured the variation in postoperative HRQOL across hospitals, and the effect of risk and reliability adjustment on hospital ranking. RESULTS: In this cohort, HRQOL varied by 56% (HALex) and 37% (BQL) across hospitals. Patient factors accounted for 58% (HALex) to 71% (BQL) of the variation in HRQOL across hospitals. After risk and reliability adjustment, HRQOL varied by 18% (by HALex) and 14.5% (by BQL) across hospitals, and the proportion of patients who experienced a large improvement in HRQOL by HALex ranged from 33% to 69% and 67% to 92% by BQL. After adjusting for patient factors and reliability, these differences diminished to 55%-64% (HALex) and 79%-84% (BQL). CONCLUSIONS: Patient factors explain a large proportion of hospital-level variation in PROs following bariatric surgery, underscoring the importance of risk adjustment. However, some variation in PROs across hospitals remains unexplained, suggesting PROs may represent a viable indicator of hospital performance
Cohort · Quality of life (healthcare) · Retrospective cohort study · Bariatric Surgery and Outcomes · Emergency Medicine · Enhanced Recovery After Surgery · Gastric Cancer Management and Outcomes · Internal Medicine · Medicine · Nursing · Surgery
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| Citations per year | 0.11 |
|---|---|
| Citation span | 2017 - 2017 (1) |
| Highly cited | No |