Better Measures of Bariatric Surgical Quality

描述（由申请人提供）：虽然减肥手术的热情持续增长，但对质量变化的担忧是普遍的。不幸的是，质量分析工作的价值受到现有措施问题的限制。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。基于全州范围内的临床登记，密歇根州减肥手术协作（MBSC），链接到密歇根州蓝十字和蓝盾（BCBS）的支付数据，该提案有2个具体目标：具体目标1：开发减肥手术的综合质量指标。使用详细的临床数据从MBSC，我们将开发一个经验加权的综合措施，克服了许多现有的质量指标的局限性。我们将通过确定它在多大程度上解释医院水平的变化和预测随后的表现来验证综合措施。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。使用密歇根州BCBS的索赔数据，我们将研究所有接受减肥手术的患者的付款历史。基于目标1中得出的综合指标，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证和支付者、政策制定者和提供者的质量改进努力取得成功。 公共卫生相关性：更好地衡量减肥手术的质量将有助于确保越来越多的认证和支付者、政策制定者和提供者的质量改进努力取得成功。

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.