National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Brain Injury (1)
- Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cancer: Lung Cancer (2)
- Cardiovascular Conditions (3)
- Children/Adolescents (1)
- Comparative Effectiveness (6)
- Disparities (1)
- Elderly (3)
- Evidence-Based Practice (1)
- Healthcare Costs (1)
- Healthcare Utilization (1)
- Heart Disease and Health (1)
- Hospitalization (1)
- Hospital Readmissions (2)
- Hospitals (2)
- Medicare (3)
- Medication (2)
- Mortality (5)
- Neurological Disorders (1)
- Obesity (2)
- Obesity: Weight Management (2)
- Opioids (1)
- (-) Outcomes (28)
- Pain (1)
- Patient-Centered Outcomes Research (6)
- Patient Safety (2)
- Provider Performance (2)
- Public Reporting (2)
- Quality Improvement (4)
- Quality Indicators (QIs) (3)
- Quality Measures (2)
- Quality of Care (4)
- Risk (4)
- Sex Factors (1)
- (-) Surgery (28)
- Teams (1)
- Treatments (3)
- Women (2)
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 28 Research Studies DisplayedHollingsworth JM, Funk RJ, Garrison SA
Association between physician teamwork and health system outcomes after coronary artery bypass grafting.
The researchers tested whether teamwork (assessed with the bipartite clustering coefficient) among multiple providers dispersed across many care locations is a determinant of surgical outcomes by examining national Medicare data from patients undergoing CABG. They found that health systems with higher teamwork levels had significantly lower 60-day rates of emergency department visit, readmission, and mortality.
AHRQ-funded; HS020927.
Citation: Hollingsworth JM, Funk RJ, Garrison SA .
Association between physician teamwork and health system outcomes after coronary artery bypass grafting.
Circ Cardiovasc Qual Outcomes 2016 Nov;9(6):641-48. doi: 10.1161/circoutcomes.116.002714.
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Keywords: Teams, Outcomes, Medicare, Surgery, Hospital Readmissions, Cardiovascular Conditions
Varban OA, Greenberg CC, Schram J
Surgical skill in bariatric surgery: Does skill in one procedure predict outcomes for another?
Whether skill for one bariatric procedure can predict outcomes for another related procedure is unknown. This study found that video ratings of surgical skill with laparoscopic gastric bypass do not predict outcomes of laparoscopic sleeve gastrectomy. Evaluation of surgical skill with one procedure may not apply to other related procedures and may require independent assessment of surgical technical proficiency.
AHRQ-funded; R01 HS023597.
Citation: Varban OA, Greenberg CC, Schram J .
Surgical skill in bariatric surgery: Does skill in one procedure predict outcomes for another?
Surgery 2016 Nov;160(5):1172-81. doi: 10.1016/j.surg.2016.04.033.
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Keywords: Surgery, Obesity: Weight Management, Obesity, Outcomes, Provider Performance
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
Bekelis K, Gottlieb D, Su Y
Surgical clipping versus endovascular coiling for elderly patients presenting with subarachnoid hemorrhage.
The authors studied elderly Medicare patients who underwent treatment for ruptured cerebral aneurysms. They did not demonstrate a difference in mortality, rate of discharge to rehabilitation, and readmissions between surgical clipping and endovascular coiling of ruptured cerebral aneurysms, although clipping was associated with a slightly longer length of stay.
AHRQ-funded; HS021581.
Citation: Bekelis K, Gottlieb D, Su Y .
Surgical clipping versus endovascular coiling for elderly patients presenting with subarachnoid hemorrhage.
J Neurointerv Surg 2016 Sep;8(9):913-8. doi: 10.1136/neurintsurg-2015-011890.
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Keywords: Brain Injury, Surgery, Comparative Effectiveness, Outcomes, Elderly
Pradarelli JC, Varban OA, Dimick JB
Hospital variation in rates of acid-reducing medication use after laparoscopic sleeve gastrectomy.
This study assessed variation in hospital performance with laparoscopic sleeve gastrectomy using rates of acid-reducing medication use at postoperative 1 year. It concluded that across Michigan hospitals, rates of new acid-reducing medication use at 1 year after laparoscopic sleeve gastrectomy varied widely and did not correlate with traditional quality indicators.
AHRQ-funded; R01 HS023597.
Citation: Pradarelli JC, Varban OA, Dimick JB .
Hospital variation in rates of acid-reducing medication use after laparoscopic sleeve gastrectomy.
Surg Obes Relat Dis 2016 Aug;12(7):1382-89. doi: 10.1016/j.soard.2015.11.016.
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Keywords: Hospitals, Medication, Surgery, Quality Indicators (QIs), Outcomes
Fernandez FG, Furnary AP, Kosinski AS
Longitudinal follow-up of lung cancer resection from the Society of Thoracic Surgeons General Thoracic Surgery Database in patients 65 years and older.
The purpose of this paper was to provide longitudinal follow-up to the Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTSD) through linkage to the Centers for Medicare and Medicaid Services (CMS) data for patients 65 years of age or older. The researchers found that median survival after lung cancer resection was 6.7 years for pathologic stage I, 3.5 years for stage II, 2.4 years for stage III, and 2.2 years for stage IV. They concluded that CMS data complement the STS GTSD data by enabling examination of long-term survival and resource utilization in patients 65 years or older.
AHRQ-funded; HS022279.
Citation: Fernandez FG, Furnary AP, Kosinski AS .
Longitudinal follow-up of lung cancer resection from the Society of Thoracic Surgeons General Thoracic Surgery Database in patients 65 years and older.
Ann Thorac Surg 2016 Jun;101(6):2067-76. doi: 10.1016/j.athoracsur.2016.03.034.
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Keywords: Cancer: Lung Cancer, Surgery, Elderly, Outcomes, Mortality
Scally CP, Varban OA, Carlin AM
Video ratings of surgical skill and late outcomes of bariatric surgery.
The authors sought to study the association between surgical skill and long-term outcomes of bariatric surgery. They found that surgical skill did not affect postoperative weight loss or resolution of medical comorbidities at 1 year after laparoscopic gastric bypass. They suggested that long-term outcomes after bariatric surgery may be less dependent on a surgeon's operative skill and instead be driven by other factors.
AHRQ-funded; HS023597.
Citation: Scally CP, Varban OA, Carlin AM .
Video ratings of surgical skill and late outcomes of bariatric surgery.
JAMA Surg 2016 Jun 15;151(6):e160428. doi: 10.1001/jamasurg.2016.0428.
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Keywords: Surgery, Obesity: Weight Management, Obesity, Quality of Care, Outcomes
Bangalore S, Guo Y, Samadashvili Z
Revascularization in patients with multivessel coronary artery disease and severe left ventricular systolic dysfunction: everolimus-eluting stents versus coronary artery bypass graft surgery.
This study compared outcomes for patients with multivessel disease and severe left ventricular systolic dysfunction (ejection fraction </=35%) who underwent either percutaneous coronary intervention (PCI) with everolimus-eluting stent or coronary artery bypass graft surgery (CABG). It found that PCI with everolimus-eluting stent had comparable long-term survival in comparison with CABG. PCI was associated with higher risk of myocardial infarction (in those with incomplete revascularization) and repeat revascularization.
AHRQ-funded; HS023683.
Citation: Bangalore S, Guo Y, Samadashvili Z .
Revascularization in patients with multivessel coronary artery disease and severe left ventricular systolic dysfunction: everolimus-eluting stents versus coronary artery bypass graft surgery.
Circulation 2016 May 31;133(22):2132-40. doi: 10.1161/circulationaha.115.021168.
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Keywords: Cardiovascular Conditions, Heart Disease and Health, Surgery, Outcomes, Risk
Healy MA, Yin H, Wong SL
Multimodal cancer care in poor prognosis cancers: resection drives long-term outcomes.
The researchers compared effects of resection with other therapies on long-term outcomes across U.S. hospitals. They examined claims in the Surveillance, Epidemiology, and End Results (SEER) Medicare dataset for patients with esophageal and pancreatic cancers and found that a significant association exists between long-term survival and rates of cancer-directed surgery across hospitals, without variation in rates of other therapies.
AHRQ-funded; HS020937.
Citation: Healy MA, Yin H, Wong SL .
Multimodal cancer care in poor prognosis cancers: resection drives long-term outcomes.
J Surg Oncol 2016 May;113(6):599-604. doi: 10.1002/jso.24217.
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Keywords: Cancer, Outcomes, Surgery, Treatments, Disparities
Moghavem N, McDonald K, Ratliff JK
Performance measures in neurosurgical patient care: differing applications of patient safety indicators.
The researchers sought to determine how Patient Safety Indicator (PSI) rates and their impact on other outcomes in patients undergoing cranial neurosurgery compared with other surgeries.. They found that procedure indication was strongly associated with PSI development. The neurosurgical population had significantly higher risk-adjusted ratios of most PSIs evaluated compared with other surgical patients. Development of a PSI was strongly associated with increased length of stay and hospital cost.
AHRQ-funded; HS018558.
Citation: Moghavem N, McDonald K, Ratliff JK .
Performance measures in neurosurgical patient care: differing applications of patient safety indicators.
Med Care 2016 Apr;54(4):359-64. doi: 10.1097/mlr.0000000000000490.
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Keywords: Quality Indicators (QIs), Surgery, Hospitalization, Outcomes, Quality of Care
Wancata LM, Banerjee M, Muenz DG
Conditional survival in advanced colorectal cancer and surgery.
The authors evaluated the impact of cancer-directed surgery on long-term survival in patients with advanced colorectal cancer (CRC). They found that five-year disease-specific conditional survival improves dramatically over time for selected patients with advanced CRC who undergo cancer-directed surgery.
AHRQ-funded; HS020937.
Citation: Wancata LM, Banerjee M, Muenz DG .
Conditional survival in advanced colorectal cancer and surgery.
J Surg Res 2016 Mar;201(1):196-201. doi: 10.1016/j.jss.2015.10.021.
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Keywords: Cancer: Colorectal Cancer, Mortality, Outcomes, Patient-Centered Outcomes Research, Surgery
Schlitz NK, Kaiboriboon K, Koroukian SM
Long-term reduction of health care costs and utilization after epilepsy surgery.
This study assessed long-term direct medical costs, health care utilization, and mortality following resective surgery in persons with uncontrolled epilepsy. It found that the mean direct medical cost difference between the surgical group and control group was $6,806 after risk-set matching. The incidence rate ratio of inpatient, emergency room, and outpatient utilization was lower among the surgical group in both unadjusted and adjusted analyses.
AHRQ-funded; HS000059.
Citation: Schlitz NK, Kaiboriboon K, Koroukian SM .
Long-term reduction of health care costs and utilization after epilepsy surgery.
Epilepsia 2016 Feb;57(2):316-24. doi: 10.1111/epi.13280.
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Keywords: Healthcare Costs, Healthcare Utilization, Mortality, Neurological Disorders, Outcomes, Surgery
Rajaram R, Paruch JL, Mohanty S
Patterns and predictors of chemotherapy use for resected non-small cell lung cancer.
The researchers sought to evaluate chemotherapy use in resected stage IB to IIIA non-small cell lung cancer (NSCLC) over time and to identify predictors of perioperative chemotherapy administration. They found that the use of chemotherapy has significantly increased in patients with resected stage IB to IIIA NSCLC.
AHRQ-funded; HS000078.
Citation: Rajaram R, Paruch JL, Mohanty S .
Patterns and predictors of chemotherapy use for resected non-small cell lung cancer.
Ann Thorac Surg 2016 Feb;101(2):533-40. doi: 10.1016/j.athoracsur.2015.08.077..
Keywords: Treatments, Cancer: Lung Cancer, Surgery, Outcomes, Quality Improvement
Shah RK, Stey AM, Jantana KR
Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.
This study evaluated perioperative outcomes in pediatric otolaryngology through analysis of records residing in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (ACS-NSQIP) database. It found that although the overall rate of major postoperative morbidity in pediatric otolaryngology is low, the following areas may be targeted for targeted quality-improvement interventions: tracheostomy, airway reconstruction, mastoidectomy, and abscess drainage.
AHRQ-funded; HS022932
Citation: Shah RK, Stey AM, Jantana KR .
Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.
JAMA Otolaryngol Head Neck Surg. 2014 Nov;140(11):1019-26. doi: 10.1001/jamaoto.2014.2067..
Keywords: Surgery, Children/Adolescents, Quality Improvement, Outcomes, Patient-Centered Outcomes Research
Duffy RP, Adams JE, Callas PW
The influence of gender on functional outcomes of lower extremity bypass.
The researchers aimed to evaluate the effect of gender on early and late procedural and functional outcomes of lower extremity bypass (LEB). They found that women have complication rates similar to men with inferior early and late functional outcomes after LEB. The reduced patency rates in women with critical limb ischemia did not translate into differences in limb salvage.
AHRQ-funded; HS021581.
Citation: Duffy RP, Adams JE, Callas PW .
The influence of gender on functional outcomes of lower extremity bypass.
J Vasc Surg 2014 Nov;60(5):1282-90, 90.e1. doi: 10.1016/j.jvs.2014.05.008.
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Keywords: Cardiovascular Conditions, Outcomes, Sex Factors, Surgery
Goode AP, Richardson WJ, Schectman RM
Complications, revision fusions, readmissions, and utilization over a 1-year period after bone morphogenetic protein use during primary cervical spine fusions.
The authors sought to determine the 1-year risk of complications, cervical revision fusions, hospital readmissions, and health care services utilization after bone morphogenetic protein (BMP) use with cervical spine fusions. They found that patients receiving BMP were 29% more likely to have a complication and a nervous system complication; cervical revision fusions were more likely among patients receiving BMP; the risk of 30-day readmission was greater with BMP use; and readmission occurred 27.4% sooner on an average. Additionally, patients receiving BMP were more likely to receive computed tomography scans and epidurals with anterior surgical approaches.
AHRQ-funded; HS019479.
Citation: Goode AP, Richardson WJ, Schectman RM .
Complications, revision fusions, readmissions, and utilization over a 1-year period after bone morphogenetic protein use during primary cervical spine fusions.
Spine J 2014 Sep;14(9):2051-9. doi: 10.1016/j.spinee.2013.11.042.
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Keywords: Adverse Events, Hospital Readmissions, Patient Safety, Outcomes, Patient-Centered Outcomes Research, Surgery, Treatments
Abdelsattar ZM, Krell RW, Campbell Jr DA
Differences in hospital performance for noncancer vs cancer colorectal surgery.
The researchers investigated the differences in hospital performance for noncancer and cancer colorectal resections at 52 Michigan hospitals. They found that hospital performance ranking in risk-adjusted outcomes (mortality, morbidity, length of stay) after noncancer colorectal resections does not correlate with performance for cancer-related colorectal resections.
AHRQ-funded; HS000053; HS20937
Citation: Abdelsattar ZM, Krell RW, Campbell Jr DA .
Differences in hospital performance for noncancer vs cancer colorectal surgery.
J Am Coll Surg. 2014 Sep;219(3):450-9. doi: 10.1016/j.jamcollsurg.2014.02.034..
Keywords: Outcomes, Surgery, Quality of Care
Huesch MD
The impact of short breaks from cardiac surgery on mortality and stay length in California.
In this small, exploratory study, the researchers sought to investigate potential surgical “forgetting” among cardiac surgeons taking a break from performing isolated coronary artery bypass graft (CABG) surgery in a large state-wide study in California. Patients operated on by surgeons who had not performed isolated CABG in the prior calendar month stayed in hospital 0.5 day longer.
AHRQ-funded; HS021868.
Citation: Huesch MD .
The impact of short breaks from cardiac surgery on mortality and stay length in California.
J Healthc Qual 2014 Sep-Oct;36(5):42-9. doi: 10.1111/jhq.12018..
Keywords: Surgery, Outcomes, Mortality, Risk
Antonescu I, Scott S, Tran TT
Measuring postoperative recovery: what are clinically meaningful differences?
This paper's objective was to generate minimal clinically important difference (MCID) estimates for three postoperative recovery metrics. On the data analyzed, MCIDs were consistently smaller for patients rating their health as "excellent" or "very good" compared with those for patients rating their health as "fair" or "poor." The authors provided MCIDs and ranges around each estimate and recommended that these values be considered when planning and interpreting abdominal surgery clinical trials where patient-reported outcomes are assessed.
AHRQ-funded; HS021857.
Citation: Antonescu I, Scott S, Tran TT .
Measuring postoperative recovery: what are clinically meaningful differences?
Surgery 2014 Aug;156(2):319-27. doi: 10.1016/j.surg.2014.03.005.
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Keywords: Outcomes, Surgery
Maggard-Gibbons M
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
This review summarized the history of American College of Surgeons National Surgical Quality Improvement Project and its components, and described the evidence that feeding outcomes back to providers, along with real-time comparisons with other hospital rates, leads to quality improvement, better patient outcomes, cost savings and overall improved patient safety.
AHRQ-funded; 2902007100621.
Citation: Maggard-Gibbons M .
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
BMJ Qual Saf 2014 Jul;23(7):589-99. doi: 10.1136/bmjqs-2013-002223..
Keywords: Quality Improvement, Quality Indicators (QIs), Quality Measures, Quality of Care, Surgery, Patient Safety, Outcomes, Patient-Centered Outcomes Research, Provider Performance
Cox CL, Huston LJ, Dunn WR
Are articular cartilage lesions and meniscus tears predictive of IKDC, KOOS, and Marx activity level outcomes after anterior cruciate ligament reconstruction? A 6-year multicenter cohort study.
This study of 1,512 ACLR patients who were followed for 6 years found that both articular cartilage injury and meniscus tears/treatment at the time of ACLR were significant predictors of International Knee Documentation Center (IKDC) and Knee injury Osteoarthritis Outcome Score (KOOS) scores after ACLR. Having a grade 4 medial femoral condyle lesion significantly reduced a patient’s Marx activity level score at 6 years.
AHRQ-funded; HS016075
Citation: Cox CL, Huston LJ, Dunn WR .
Are articular cartilage lesions and meniscus tears predictive of IKDC, KOOS, and Marx activity level outcomes after anterior cruciate ligament reconstruction? A 6-year multicenter cohort study.
Am J Sports Med. 2014 May;42(5):1058-67. doi: 10.1177/0363546514525910..
Keywords: Outcomes, Surgery, Risk
Martin BI, Lurie JD, Tosteson AN
Indications for spine surgery: validation of an administrative coding algorithm to classify degenerative diagnoses.
The Spine Patient Outcomes Research Trial (SPORT) provided a unique opportunity to examine the validity of a claims-based algorithm for grouping patients by surgical indication. SPORT enrolled patients for lumbar disc herniation, spinal stenosis, and degenerative spondylolisthesis. The researchers found that their claims-based hierarchical coding algorithm of spine-related medical encounters correctly classified more than 90 percent of Medicare patients into their respective SPORT cohorts.
AHRQ-funded; HS018405
Citation: Martin BI, Lurie JD, Tosteson AN .
Indications for spine surgery: validation of an administrative coding algorithm to classify degenerative diagnoses.
Spine. 2014 Apr 20;39(9):769-79. doi: 10.1097/brs.0000000000000275..
Keywords: Comparative Effectiveness, Surgery, Outcomes, Medicare
Jones WS, Dolor RJ, Hasselblad V
Comparative effectiveness of endovascular and surgical revascularization for patients with peripheral artery disease and critical limb ischemia: systematic review of revascularization in critical limb ischemia.
This systematic review found that there is no difference in clinical outcomes for patients with critical limb ischemia treated with endovascular or surgical revascularization. This review of 23 studies found no differences in overall death, amputation, or amputation-free survival at 2 or more years following treatment.
AHRQ-funded; 290200710066I
Citation: Jones WS, Dolor RJ, Hasselblad V .
Comparative effectiveness of endovascular and surgical revascularization for patients with peripheral artery disease and critical limb ischemia: systematic review of revascularization in critical limb ischemia.
Am Heart J. 2014 Apr;167(4):489-498.e7. doi: 10.1016/j.ahj.2013.12.012..
Keywords: Comparative Effectiveness, Outcomes, Surgery, Mortality
Kim DH, Lin Y, Goytizolo EA
Adductor canal block versus femoral nerve block for total knee arthroplasty: a prospective, randomized, controlled trial.
In a study of pain relief for patients recovering from a total knee arthroplasty, researchers found that adductor canal block (ACB) results in less motor impairment for quadriceps muscles after surgery than femoral nerve block (FNB) and it provides a comparable level of pain relief. The prospective, randomized, controlled study included 46 patients receiving ACB and 47 receiving FNB.
AHRQ-funded; HS021734
Citation: Kim DH, Lin Y, Goytizolo EA .
Adductor canal block versus femoral nerve block for total knee arthroplasty: a prospective, randomized, controlled trial.
Anesthesiology. 2014 Mar;120(3):540-50. doi: 10.1097/ALN.0000000000000119..
Keywords: Medication, Opioids, Outcomes, Pain, Surgery
Dahlke AR, Chung JW, Holl JL
Evaluation of initial participation in public reporting of American College of Surgeons NSQIP surgical outcomes on Medicare's Hospital Compare website.
The objective of this paper was to compare CMS-National Surgical Quality Improvement Program (CMS-NSQIP) participating hospitals with American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) hospitals that elected not to participate in Hospital Compare. The researchers found few measurable differences between CMS-NSQIP participating and nonparticipating hospitals.
AHRQ-funded; HS021857.
Citation: Dahlke AR, Chung JW, Holl JL .
Evaluation of initial participation in public reporting of American College of Surgeons NSQIP surgical outcomes on Medicare's Hospital Compare website.
J Am Coll Surg 2014 Mar;218(3):374-80, 80.e1-5. doi: 10.1016/j.jamcollsurg.2013.11.022.
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Keywords: Hospitals, Outcomes, Public Reporting, Quality Improvement, Surgery