Comparing definitions of outpatient surgery: Implications for quality measurement.
Comparing definitions of outpatient surgery: Implications for quality measurement.
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DOI：
10.1016/j.amjsurg.2017.01.021
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发表时间：
2017-08
影响因子：
3
通讯作者：
Rosen AK
中科院分区：
文献类型：
--
作者：
Mull HJ;Rivard PE;Legler A;Pizer SD;Hawn MT;Itani KMF;Rosen AK
门诊手术的不良事件（AE）发生率报告不一致，部分原因是缺乏门诊手术的标准定义。我们比较了两个国家医疗保健机构：医疗保健成本研究所 (HCCI) 和医疗保健成本和利用项目 (HCUP) 定义的外科手术的类型和比率，并考虑了对质量测量的影响。我们使用 HCCI 和 HCUP 定义来识别 2012-14 财年 VA 门诊手术。 HCCI 手术数量是 HCUP 的六倍（6,575,830 例对 1,086,640 例）。 99% 的 HCUP 定义的手术也由 HCCI 识别。更多 HCUP 手术的平均医疗保险相对价值单位高于 HCCI 手术 [5.3 (SD=4.4) vs 1.6 (SD=2.3) RVU]。不同定义之间的费用和程序类型差异很大。与 HCUP 相比，使用 HCCI 进行质量测量可能会显着降低 AE 发生率，因为其中的许多手术反映了较低的复杂性和潜在的较低 AE 风险。如果使用不同的门诊手术定义进行分析，门诊手术的质量测量可能会不一致。我们使用退伍军人健康管理局的数据比较了两个国家医疗机构定义的外科手术的类型和比率。我们发现差异很大，这意味着如果没有门诊手术质量的标准定义，测量结果将是不可靠的。
Adverse event (AE) rates in outpatient surgery are inconsistently reported, partly because of the lack of a standard definition of outpatient surgery. We compared the types and rates of surgical procedures defined by two national healthcare agencies: Health Care Cost Institute (HCCI) and the Healthcare Cost and Utilization Project (HCUP) and considered implications for quality measurement. We used HCCI and HCUP definitions to identify FY2012–14 VA outpatient surgeries. There were six times as many HCCI surgeries as HCUP (6,575,830 versus 1,086,640). Ninety-nine percent of HCUP-defined surgeries were also identified by HCCI. More HCUP surgeries had higher average Medicare Relative Value Units then HCCI surgeries [5.3 (SD=4.4) versus 1.6 (SD=2.3) RVUs]. Rates and types of procedures vary widely between definitions. Quality measurement using HCCI versus HCUP may produce significantly lower AE rates because many of the surgeries included reflect low complexity and potentially low risk of AEs. Quality measurement in outpatient surgery may be inconsistent if different definitions of outpatient surgery are used for analysis. We compared the types and rates of surgical procedures defined by two national healthcare agencies using data from the Veterans Health Administration. We found wide variation, implying that without a standard definition of outpatient surgery quality measurement will be unreliable.
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影响因子：
9
作者：
Mezei, G;Chung, F
通讯作者：
Chung, F
影响因子：
--
作者：
Neily, Julia;Mills, Peter D.;Bagian, James P.
通讯作者：
Bagian, James P.
影响因子：
3
作者：
Elixhauser, A;Steiner, C;Coffey, RN
通讯作者：
Coffey, RN
DOI：
10.1007/s12630-013-9916-8
发表时间：
2013-06-01
影响因子：
4.2
作者：
Morgan, Pamela J.;Cunningham, Lisa;Semple, John
通讯作者：
Semple, John
影响因子：
6.7
作者：
Coley, KC;Williams, BA;Smith, RB
通讯作者：
Smith, RB