Superficial surgical site infections are a reliable measure of hospital quality
Research Activities, February 2012, No. 378
The most common complication following surgery is a superficial infection at the surgical site (SSI). Rates of these infections are now being used as a measure of hospital quality. Interest is mounting as the Centers for Medicare & Medicaid Services will publically report on SSI rates on their Hospital Compare Web site. A new study that looked at SSIs in patients undergoing colon surgery found that once an adequate number of SSI cases had been reported, the rates of SSI were a reliable measure of hospital quality of care.
The researchers examined the records of 18,455 patients who underwent colon resection at 181 hospitals. All of the hospitals were participants in the American College of Surgeons National Surgical Quality Improvement Program. Risk-adjusted rates of SSI were determined based on a variety of patient risk factors. On average, each hospital performed 102 colon resections in 2007. SSI rates (adjusted for patient risk factors for infection) ranged from 0 to 30 percent, with a mean of 10.5 percent. More than half (54 percent) of the hospitals had a reliability of more than 0.70, considered a minimum acceptable level. This was based on having at least 94 cases of SSI at a given hospital. According to the researchers, additional methods are needed to increase the reliability of these measured outcomes. The study was supported in part by the Agency for Healthcare Research and Quality (HS17765).
See "Reliability of superficial surgical site infections as a hospital measure," by Lillian S, Kao, M.D., M.S., FACS, Amir A. Ghaferi, M.D., M.S., Clifford Y. Ko, M.D., M.S., M.S.H.S., FACS., and Justin B. Dimick, M.D., M.P.H., FACS., in the August 2011 Journal of the American College of Surgeons 213(2), pp. 231-235.