Better Measures of Bariatric Surgical Quality

描述（由申请人提供）：虽然对减肥手术的热情持续增长，但对质量变化的担忧普遍存在。不幸的是，质量分析工作的价值受到现有度量方法问题的限制。此外，尽管人们对基于价值的购买越来越感兴趣，但几乎没有证据表明减肥手术的质量和成本之间存在联系。该提案基于密歇根州减肥手术合作组织（MBSC）的全州临床登记，并与密歇根州蓝十字和蓝盾（BCBS）的支付数据相关联，有两个具体目标：具体目标1：制定减肥手术的综合质量衡量标准。利用来自MBSC的详细临床数据，我们将开发一种经验加权的复合测量方法，克服现有质量指标的许多局限性。我们将通过确定其解释医院水平变化和预测后续表现的程度来验证复合措施。具体目标2：更好地了解减肥手术的质量和成本之间的关系。使用密歇根BCBS的索赔数据，我们将研究所有接受减肥手术的患者的支付历史。基于Aim 1中导出的综合度量，我们将评估医院质量和成本之间的关系。更好地衡量减肥手术的质量将有助于确保越来越多的认可和付款人、政策制定者和提供者的质量改进工作的成功。

DESCRIPTION (provided by applicant): While enthusiasm for bariatric surgery continues to grow, concerns regarding variations in quality are pervasive. Unfortunately, the value of quality profiling efforts is limited by problems with the existing measures. Further, despite a growing interest in value-based purchasing, there is little evidence linking quality and costs for bariatric surgery. Based on a statewide clinical registry, the Michigan Bariatric Surgery Collaborative (MBSC), linked to payment data from Blue Cross and Blue Shield of Michigan (BCBS), this proposal has 2 specific aims: Specific Aim 1: To develop a composite quality measure for bariatric surgery. Using detailed clinical data from the MBSC, we will develop an empirically weighted composite measure that overcomes many of the limitations of existing quality indicators. We will validate the composite measures by determining the extent to which it explains hospital level variation and forecasts subsequent performance. Specific Aim 2: To better understand the relationship between quality and costs for bariatric surgery. Using claims data from BCBS of Michigan, we will study the payment history of all patients undergoing bariatric surgery. Based on the composite measure derived in Aim 1, we will then assess relationships between hospital quality and costs. Better measures of quality for bariatric surgery will help ensure the success of the growing number of accreditation and quality improvement efforts of payers, policymakers, and providers. PUBLIC HEALTH RELEVANCE: Better measures of quality for bariatric surgery will help ensure the success of the growing number of accreditation and quality improvement efforts of payers, policymakers, and providers.