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In a previous life I worked for cardiac surgeons - one of them was on a board for the State of Florida to research outcomes and how to publish them without affe
by ckluis 10y ago
In a previous life I worked for cardiac surgeons - one of them was on a board for the State of Florida to research outcomes and how to publish them without affecting which cases are taken.
In the case of one example where NY started publishing outcomes the difficult cases switched to the Cleveland Clinic. The outcomes appearred to increase in NY and decrease at the Cleveland Clinic, but risk adjusted rates didn’t actually change for NY hospitals that transferred cases or for the Cleveland Clinic.
This is absolutely something that happens and Cardiac Surgeons are all scientists to some degree. The results and risk adjustments are very well documented and they can determine them with a fair degree of accuracy. I’m not aware of the info for this particular case, but if they did risk adjust (the patient) it right - there are still a lot of other factors that determine quality of care (speed of delivery of service) and quantity of surgerys performed (if you don’t perform enough surgeries per year your quality suffers). Incidently, this is true for surgical staff (nurses) as well. If the surgeon travels to numerous to hospitals… the hospitals with the most surgeries performed will have better outcomes (after risk adjustment for them doing higher risk surgeries).
- et2o 10y agoIt's not that some surgeries are being shifted from one center to another, its that no one at all will do them, generally to the detriment of the patient.
- gozur88 10y agoSomeone will do them. There is a business model for surgeons who only take the sickest patients. Sure, in that case your numbers are worse, but that's the way you market yourself.