National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- (-) Adverse Events (27)
- Ambulatory Care and Surgery (1)
- Cancer: Breast Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (2)
- Children/Adolescents (3)
- Communication (1)
- Comparative Effectiveness (3)
- Diagnostic Safety and Quality (1)
- Dialysis (1)
- Digestive Disease and Health (1)
- Disparities (1)
- Education: Continuing Medical Education (1)
- Elderly (4)
- Eye Disease and Health (1)
- Healthcare-Associated Infections (HAIs) (4)
- Healthcare Cost and Utilization Project (HCUP) (4)
- Healthcare Costs (1)
- Heart Disease and Health (2)
- Hospital Readmissions (3)
- Hospitals (5)
- Injuries and Wounds (5)
- Kidney Disease and Health (1)
- Medical Errors (2)
- Medical Liability (1)
- Medicare (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Mortality (5)
- Obesity (2)
- Orthopedics (1)
- Outcomes (1)
- Patient-Centered Outcomes Research (5)
- Patient Safety (9)
- Public Reporting (1)
- Quality Indicators (QIs) (2)
- Quality Measures (3)
- Quality of Care (2)
- Research Methodologies (1)
- Risk (8)
- (-) Surgery (27)
- Training (1)
- Transplantation (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 27 Research Studies DisplayedMello MM, Greenberg Y, Senecal SK
Case outcomes in a communication-and-resolution program in New York hospitals.
The researchers sought to determine case outcomes in a communication-and-resolution program (CRP) implemented to respond to adverse events in general surgery. They concluded that the bulk of CRPs' work is in investigating and communicating about events not caused by substandard care. These CRPs were quite successful in handling such events, but less consistent in offering compensation in cases involving substandard care.
AHRQ-funded; R18 HS019505.
Citation: Mello MM, Greenberg Y, Senecal SK .
Case outcomes in a communication-and-resolution program in New York hospitals.
Health Serv Res 2016 Dec;51 Suppl 3:2583-99. doi: 10.1111/1475-6773.12594.
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Keywords: Adverse Events, Communication, Medical Errors, Medical Liability, Surgery
Pershing S, Morrison DE, Hernandez-Boussard T
Cataract surgery complications and revisit rates among three states.
The authors studied cataract procedures from California, Florida, and New York, to characterize population-based 30-day procedure-related readmissions following surgery. Their results highlight the importance of age as a risk factor for cataract surgery readmissions, and suggest a relationship between black or Hispanic race, Medicaid insurance, and diabetes associated with higher risk for cataract surgery complications.
AHRQ-funded; HS018558.
Citation: Pershing S, Morrison DE, Hernandez-Boussard T .
Cataract surgery complications and revisit rates among three states.
Am J Ophthalmol 2016 Nov;171:130-38. doi: 10.1016/j.ajo.2016.08.036.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Eye Disease and Health, Surgery, Hospital Readmissions, Adverse Events
Pradarelli JC, Healy MA, Osborne NH
Variation in Medicare expenditures for treating perioperative complications: the cost of rescue.
The researchers evaluated differences across hospitals in the costs of care for patients surviving perioperative complications after major inpatient surgery. After 4 selected inpatient operations, substantial variation was observed across hospitals regarding Medicare episode payments for patients rescued from perioperative complications. Notably, higher Medicare payments were not associated with improved clinical performance.
AHRQ-funded; HS017765.
Citation: Pradarelli JC, Healy MA, Osborne NH .
Variation in Medicare expenditures for treating perioperative complications: the cost of rescue.
JAMA Surg 2016 Oct 5:e163340. doi: 10.1001/jamasurg.2016.3340.
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Keywords: Medicare, Adverse Events, Surgery, Healthcare Costs, Patient Safety
Waljee JF, Ghaferi A, Cassidy R
Are patient-reported outcomes correlated with clinical outcomes after surgery? A population-based study.
The researchers evaluated the extent to which patient-reported outcomes (eg, health-related quality of life) are distinct from clinical outcomes following bariatric surgery. They concluded that patient-reported outcomes are not correlated with early perioperative events, but are correlated with measures of clinical effectiveness after bariatric surgery.
AHRQ-funded; HS023313.
Citation: Waljee JF, Ghaferi A, Cassidy R .
Are patient-reported outcomes correlated with clinical outcomes after surgery? A population-based study.
Ann Surg 2016 Oct;264(4):682-9. doi: 10.1097/sla.0000000000001852.
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Keywords: Surgery, Obesity, Adverse Events, Patient-Centered Outcomes Research, Patient Safety
Ban KA, Cohen ME, Ko CY
Evaluation of the ProPublica surgeon scorecard "Adjusted Complication Rate" measure specifications.
The authors sought to (1) determine the proportion of cases excluded by ProPublica's specifications, (2) assess the proportion of inpatient complications excluded from ProPublica's measure, and (3) examine the validity of ProPublica's outcome measure by comparing performance on the measure to well-established postoperative outcome measures. They found that ProPublica's outcome measure specifications exclude 82% of cases, miss 84% of postoperative complications, and correlate poorly with well-established postoperative outcomes.
AHRQ-funded; HS021857.
Citation: Ban KA, Cohen ME, Ko CY .
Evaluation of the ProPublica surgeon scorecard "Adjusted Complication Rate" measure specifications.
Ann Surg 2016 Oct;264(4):566-74. doi: 10.1097/sla.0000000000001858.
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Keywords: Adverse Events, Outcomes, Public Reporting, Quality Measures, Surgery
Morris MS, Graham LA, Richman JS
Postoperative 30-day readmission: time to focus on what happens outside the hospital.
The authors of this study aimed to understand the relative contribution of preoperative patient factors, operative characteristics, and postoperative hospital course on 30-day postoperative readmissions. They found that although postoperative readmissions are difficult to predict at the time of discharge, preoperative factors are the most important.
AHRQ-funded; HS013852.
Citation: Morris MS, Graham LA, Richman JS .
Postoperative 30-day readmission: time to focus on what happens outside the hospital.
Ann Surg 2016 Oct;264(4):621-31. doi: 10.1097/sla.0000000000001855.
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Keywords: Hospital Readmissions, Surgery, Adverse Events, Risk, Risk
Tedesco D, Hernandez-Boussard T, Carretta E
Evaluating patient safety indicators in orthopedic surgery between Italy and the USA.
The authors compared patient safety in major orthopedic procedures between an orthopedic hospital in Italy and 26 Florida hospitals of similar size. AHRQ Patient Safety Indicators (PSIs) were used to identify inpatient adverse events (AEs). They found that US patients had lower adjusted odds of developing a PSI compared to Italy for pressure ulcers, hemorrhage or hematoma, and physiologic and metabolic derangement. while Italian patients had lower odds of pulmonary embolism/deep vein thrombosis compared to US patients.
AHRQ-funded; HS018558.
Citation: Tedesco D, Hernandez-Boussard T, Carretta E .
Evaluating patient safety indicators in orthopedic surgery between Italy and the USA.
Int J Qual Health Care 2016 Sep;28(4):486-91. doi: 10.1093/intqhc/mzw053.
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Keywords: Adverse Events, Orthopedics, Patient Safety, Quality Indicators (QIs), Surgery
Dimou FM, Adhikari D, Mehta HB
Incidence of hepaticojejunostomy stricture after hepaticojejunostomy.
The authors aimed to determine the timing, incidence, and management of stricture after biliary-enteric anastomosis. They found that younger age was associated with a decreased likelihood of stricture formation and that the presence of an endostent predicted stricture formation. They concluded that biliary-enteric anastomotic strictures occur with significant frequency after a biliary-enteric anastomosis, and that while many patients are managed nonoperatively, stricture diagnosis remains burdensome.
AHRQ-funded; HS022134.
Citation: Dimou FM, Adhikari D, Mehta HB .
Incidence of hepaticojejunostomy stricture after hepaticojejunostomy.
Surgery 2016 Sep;160(3):691-8. doi: 10.1016/j.surg.2016.05.021.
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Keywords: Surgery, Adverse Events, Digestive Disease and Health, Elderly, Patient-Centered Outcomes Research
McLeod L, Flynn J, Erickson M
Variation in 60-day readmission for surgical-site infections (SSIs) and reoperation following spinal fusion operations for neuromuscular scoliosis.
The purpose of this study was to examine variation in hospital performance based on risk-standardized 60-day readmission rates for surgical-site infection (SSIs) and reoperation across 39 US Children's Hospitals. It found that reoperations were associated with an SSI in 70 percent of cases. Across hospitals, SSI and reoperation rates ranged from 1 percent to 11 percent and 1 percent to 12 percent, respectively.
AHRQ-funded; HS022198.
Citation: McLeod L, Flynn J, Erickson M .
Variation in 60-day readmission for surgical-site infections (SSIs) and reoperation following spinal fusion operations for neuromuscular scoliosis.
J Pediatr Orthop 2016 Sep;36(6):634-9. doi: 10.1097/bpo.0000000000000495.
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Keywords: Children/Adolescents, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Hospital Readmissions, Hospitals, Risk
Simianu VV, Flum DR
Rethinking elective colectomy for diverticulitis: a strategic approach to population health.
The authors argue that a rethinking of elective colectomy should come from a patient-centered approach that considers the risks of recurrence, quality of life, patient wishes and experiences about surgical and medical treatment options as well as operative morbidity and risks.
AHRQ-funded; HS020025.
Citation: Simianu VV, Flum DR .
Rethinking elective colectomy for diverticulitis: a strategic approach to population health.
World J Gastroenterol 2014 Nov 28;20(44):16609-14. doi: 10.3748/wjg.v20.i44.16609..
Keywords: Patient-Centered Outcomes Research, Comparative Effectiveness, Surgery, Adverse Events, Risk
Minami CA, Dahlke AR, Barnard C
Association between hospital characteristics and performance on the new hospital-acquired condition reduction program's surgical site infection measures.
This research letter evaluated the association between hospital characteristics and surgical site infection (SSI) measures. The authors found that hospitals with higher hospital quality summary scores were more frequently poor performers for SSI and had higher standardized infection ratios. Hospitals were more likely to be poor performers for colon SSI and hysterectomy SSI if they were a teaching hospital, safety-net hospital, or level I trauma center. Teaching hospitals were more likely to be poor performers for colorectal SSI, but the association was not as consistent for hysterectomy.
AHRQ-funded; HS021857.
Citation: Minami CA, Dahlke AR, Barnard C .
Association between hospital characteristics and performance on the new hospital-acquired condition reduction program's surgical site infection measures.
JAMA Surg 2016 Aug;151(8):777-9. doi: 10.1001/jamasurg.2016.0408.
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Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Adverse Events, Quality Measures, Hospitals, Quality of Care
Healy MA, Grenda TR, Suwanabol PA
Colon cancer operations at high- and low-mortality hospitals.
The authors sought to evaluate causes of mortality following colon cancer operations across hospitals. They found significant variation in mortality across hospitals for colon cancer operations, reflecting a need for improved operative decision-making to enhance outcomes and quality of care.
AHRQ-funded; HS020937; HS023621; HS000053.
Citation: Healy MA, Grenda TR, Suwanabol PA .
Colon cancer operations at high- and low-mortality hospitals.
Surgery 2016 Aug;160(2):359-65. doi: 10.1016/j.surg.2016.04.035.
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Keywords: Adverse Events, Cancer: Colorectal Cancer, Mortality, Patient Safety, Surgery
Mehta HB, Parmar AD, Adhikari D
Relative impact of surgeon and hospital volume on operative mortality and complications following pancreatic resection in Medicare patients.
This study's objective was to evaluate the relative effects of surgeon and hospital volume on mortality and complications after pancreatic resection among older patients. The researchers used Texas Medicare data and found that high surgeon volume and high hospital volume were associated with lower risk of mortality, while high surgeon volume was also associated with lower risk of complications.
AHRQ-funded; HS022134.
Citation: Mehta HB, Parmar AD, Adhikari D .
Relative impact of surgeon and hospital volume on operative mortality and complications following pancreatic resection in Medicare patients.
J Surg Res 2016 Aug;204(2):326-34. doi: 10.1016/j.jss.2016.05.008.
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Keywords: Adverse Events, Elderly, Hospitals, Mortality, Surgery
Rinke ML, Jan D, Nassim J
Surgical site infections following pediatric ambulatory surgery: an epidemiologic analysis.
The authors identified surgical site infection (SSI) rates following pediatric ambulatory surgery, SSI outcomes and risk factors, and sensitivity and specificity of SSI administrative billing codes. They concluded that SSI following pediatric ambulatory surgery occurs at an appreciable rate and conveys morbidity on children.
AHRQ-funded; HS021282.
Citation: Rinke ML, Jan D, Nassim J .
Surgical site infections following pediatric ambulatory surgery: an epidemiologic analysis.
Infect Control Hosp Epidemiol 2016 Aug;37(8):931-8. doi: 10.1017/ice.2016.98.
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Keywords: Children/Adolescents, Ambulatory Care and Surgery, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Risk
Hernandez-Boussard TM, McDonald KM, Morrison DE
Risks of adverse events in colorectal patients: population-based study.
The authors sought to assess adverse events in colorectal surgical patients. They found important differential rates of adverse events by diagnostic category, with the highest odds ratio occurring in patients undergoing surgery for ischemic colitis.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard TM, McDonald KM, Morrison DE .
Risks of adverse events in colorectal patients: population-based study.
J Surg Res 2016 May 15;202(2):328-34. doi: 10.1016/j.jss.2016.01.013.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Surgery, Patient Safety, Risk, Quality Indicators (QIs), Quality of Care, Quality Measures
Greenberg JK, Olsen MA, Yarbrough CK
Chiari malformation type I surgery in pediatric patients. Part 2: complications and the influence of comorbid disease in California, Florida, and New York.
The objective of this study was to investigate Chiari malformation Type I (CM-I) surgical outcomes using population-level administrative billing data. It concluded that approximately 1 in 8 pediatric CM-I patients experienced a surgical complication, whereas medical complications were rare. Although complex chronic conditions were common in pediatric CM-I patients, only hydrocephalus was independently associated with increased risk of surgical events.
AHRQ-funded; HS019455.
Citation: Greenberg JK, Olsen MA, Yarbrough CK .
Chiari malformation type I surgery in pediatric patients. Part 2: complications and the influence of comorbid disease in California, Florida, and New York.
J Neurosurg Pediatr 2016 May;17(5):525-32. doi: 10.3171/2015.10.peds15369.
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Keywords: Adverse Events, Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Surgery
Nickel KB, Fox IK, Margenthaler JA
Effect of noninfectious wound complications after mastectomy on subsequent surgical procedures and early implant loss.
The authors determined the rates of noninfectious wound complications (NIWCs) among women undergoing mastectomy and assessed the impact of immediate reconstruction (IR). They found that the rate of NIWC was approximately 2-fold higher after mastectomy with IR than after mastectomy only and that noninfectious wound complications were associated with additional surgical treatment, particularly in women with implant reconstruction, and with early implant loss.
AHRQ-funded; HS019455.
Citation: Nickel KB, Fox IK, Margenthaler JA .
Effect of noninfectious wound complications after mastectomy on subsequent surgical procedures and early implant loss.
J Am Coll Surg 2016 May;222(5):844-52.e1. doi: 10.1016/j.jamcollsurg.2016.01.050.
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Keywords: Adverse Events, Cancer: Breast Cancer, Injuries and Wounds, Surgery
Baker AW, Dicks KV, Durkin MJ
Epidemiology of surgical site infection in a community hospital network.
The researchers described the epidemiology of complex surgical site infection (SSI) following commonly performed surgical procedures in community hospitals and to characterize trends of SSI prevalence rates over time for MRSA and other common pathogens. They found that the prevalence of MRSA SSI decreased from 2008 to 2012. This decrease in MRSA SSI prevalence led to an overall decrease in SSI prevalence.
AHRQ-funded; HS023866.
Citation: Baker AW, Dicks KV, Durkin MJ .
Epidemiology of surgical site infection in a community hospital network.
Infect Control Hosp Epidemiol 2016 May;37(5):519-26. doi: 10.1017/ice.2016.13.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Injuries and Wounds, Adverse Events, Risk, Hospitals
Vargas GM, Sieloff EP, Parmar AD
Laparoscopy decreases complications for obese patients undergoing elective rectal surgery.
This paper's goal was to determine whether obese patients undergoing laparoscopic rectal surgery experienced the same benefits as non-obese patients. The researchers found that laparoscopic rectal surgery is associated with fewer complications when compared to open rectal surgery in both obese and non-obese patients, and that obesity was an independent risk factor for postoperative complications.
AHRQ-funded; HS022134.
Citation: Vargas GM, Sieloff EP, Parmar AD .
Laparoscopy decreases complications for obese patients undergoing elective rectal surgery.
Surg Endosc 2016 May;30(5):1826-32. doi: 10.1007/s00464-015-4463-8.
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Keywords: Adverse Events, Obesity, Risk, Surgery
Holcomb CN, Graham LA, Richman JS
The incremental risk of coronary stents on postoperative adverse events: a matched cohort study.
The objective of this study was to determine the incremental risk of coronary stents on adverse events in surgical patients and whether it varies over time from stent placement. It concluded that surgery after coronary stent placement is associated with an approximate 2 percent absolute risk for postoperative heart attack but no difference in mortality compared with nonstented matched controls.
AHRQ-funded; HS013852.
Citation: Holcomb CN, Graham LA, Richman JS .
The incremental risk of coronary stents on postoperative adverse events: a matched cohort study.
Ann Surg 2016 May;263(5):924-30. doi: 10.1097/sla.0000000000001246..
Keywords: Adverse Events, Risk, Surgery, Patient Safety, Heart Disease and Health, Cardiovascular Conditions
McElroy LM, Woods DM, Yanes AF
Applying the WHO conceptual framework for the International Classification for Patient Safety to a surgical population.
The researchers aimed to test the applicability of the International Classification for Patient Safety to a surgical population by developing a codebook for future use by researchers. They found that the most common severity classification was 'reportable circumstance' and that the most common incident type was 'resources/organizational management.' They noted that several aspects of surgical care were encompassed by more than one classification, including operating room scheduling, delays in care, trainee-related incidents, interruptions, and handoffs. They concluded that a framework for patient safety can be applied to facilitate the organization and analysis of surgical safety data.
AHRQ-funded; HS000078.
Citation: McElroy LM, Woods DM, Yanes AF .
Applying the WHO conceptual framework for the International Classification for Patient Safety to a surgical population.
Int J Qual Health Care 2016 Apr;28(2):166-74. doi: 10.1093/intqhc/mzw001.
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Keywords: Surgery, Patient Safety, Transplantation, Adverse Events, Medical Errors
Sheetz KH, Dimick JB, Ghaferi AA
Impact of hospital characteristics on failure to rescue following major surgery.
This study determined the effect of hospital characteristics on failure to rescue after high-risk surgery in Medicare beneficiaries. It found that although several hospital characteristics are associated with lower failure to rescue rates, these macrosystem factors explain a small proportion of the variability between hospitals. This suggests that microsystem characteristics may play a larger role in improving a hospital's ability to manage postoperative complications.
AHRQ-funded; HS023621.
Citation: Sheetz KH, Dimick JB, Ghaferi AA .
Impact of hospital characteristics on failure to rescue following major surgery.
Ann Surg 2016 Apr;263(4):692-7. doi: 10.1097/sla.0000000000001414.
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Keywords: Surgery, Elderly, Adverse Events, Disparities, Mortality
Brown JR, Rezaee ME, Nichols EL
Incidence and in-hospital mortality of acute kidney injury (AKI) and dialysis-requiring AKI (AKI-D) after cardiac catheterization in the National Inpatient Sample.
This study examined cardiac catheterization or percutaneous coronary intervention (PCI) hospital discharges from the nationally representative National Inpatient Sample to determine annual population incidence rates for AKI and AKI-D in the United States from 2001 to 2011. It found that the incidence of AKI among cardiac catheterization and PCI patients has increased sharply in the United States; however, mortality has significantly declined.
AHRQ-funded; HS018443.
Citation: Brown JR, Rezaee ME, Nichols EL .
Incidence and in-hospital mortality of acute kidney injury (AKI) and dialysis-requiring AKI (AKI-D) after cardiac catheterization in the National Inpatient Sample.
J Am Heart Assoc 2016 Mar 15;5(3):e002739. doi: 10.1161/jaha.115.002739.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Mortality, Patient Safety, Surgery, Heart Disease and Health, Cardiovascular Conditions, Kidney Disease and Health, Dialysis, Hospitals
Gurm HS, Sanz-Guerrero J, Johnson DD
Using simulation for teaching femoral arterial access: a multicentric collaboration.
The purpose of this paper was to assess the impact of simulation training on complications associated with femoral arterial access obtained by first year cardiology fellows. The authors found that incorporation of simulation in the training of first year fellows was associated with an improvement in proficiency and a clinically meaningful reduction in vascular complications.
AHRQ-funded; HS020447.
Citation: Gurm HS, Sanz-Guerrero J, Johnson DD .
Using simulation for teaching femoral arterial access: a multicentric collaboration.
Catheter Cardiovasc Interv 2016 Feb 15;87(3):376-80. doi: 10.1002/ccd.26256.
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Keywords: Adverse Events, Education: Continuing Medical Education, Patient Safety, Surgery, Training
Mehta HB, Dimou F, Adhikari D
Comparison of comorbidity scores in predicting surgical outcomes.
The purpose of this study was to compare diagnosis-based and prescription-based comorbidity scores for predicting surgical outcomes. It concluded that the Centers for Medicare and Medicaid Services-Hierarchical Condition Categories had superior performance in predicting surgical outcomes. Prescription-based scores, alone or in addition to diagnosis-based scores, were not better than any diagnosis-based scoring system.
AHRQ-funded; HS022134.
Citation: Mehta HB, Dimou F, Adhikari D .
Comparison of comorbidity scores in predicting surgical outcomes.
Med Care 2016 Feb;54(2):180-7. doi: 10.1097/mlr.0000000000000465..
Keywords: Comparative Effectiveness, Surgery, Research Methodologies, Diagnostic Safety and Quality, Adverse Events