According to two new studies, the American College of Surgeons' National Surgical Quality Improvement Program provides more accurate data than administrative data for driving surgical quality improvement in hospitals.
The findings from the studies were presented by researchers at the 2015 ACS NSQIP National Conference in Chicago.
In the first study, investigators from Falls Church, Va.-based Inova Health System examined the validity of two sources of information for surgery quality metrics — ACS NSQIP clinical data and administrative claims data used for billing purposes. They looked at data for patients who had undergone general, endovascular and colorectal surgical procedures between January and December 2013 and were readmitted within 30 days of their operations.
They also had three experienced surgeons review the medical records of all readmitted patients to determine the causes for readmission, creating the "gold standard" that would be used to assess the data's agreement rate.
The researchers found the ACS NSQIP readmission reasons had a 71 percent agreement rate with the gold standard, whereas the administrative claims data had a 61 percent agreement rate. Moreover, the researchers estimated that the NSQIP analysis showed that approximately 60 percent of the hospital readmissions are potentially preventable.
In the second study, researchers from three institutions — the University of California San Diego, University of California Davis and Massachusetts General Hospital in Boston — worked to compare the ACS NSQIP data on complications and mortality rates to the National Inpatient Sample, the largest administrative database of inpatient hospital stays in the U.S.
The results of the second study showed that unadjusted complication rates were higher in hospitals in the NIS for seven out of the 11 operations, but unadjusted mortality rates in every procedure were lower in ACS NSQIP hospitals, compared to NIS.
The study authors concluded that patients at NSQIP hospitals seemed to have lower inpatient mortality rates than patients' hospitals in the NIS database.
"If a greater number of hospitals participated in NSQIP, then those hospitals could participate in more robust surgical outcomes research, which in the end really only benefits the patient," said the lead author of the second study Anna Weiss, MD, a surgical resident at UC San Diego. "It would allow more hospitals to have more accurate risk-adjusted analyses."
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