Introduction: It is unclear whether publicly reported benchmarks correlate with the quality of physicians and institutions. We investigated the association of patient satisfaction measures from a public reporting platform with the performance of neurosurgeons in New York State.
Methods: We performed a cohort study involving patients undergoing neurosurgical operations from 2009-2013, who were registered in the Statewide Planning and Research Cooperative System (SPARCS) database. This cohort was merged with publicly available data from the CMS Hospital Compare website. A propensity adjusted regression analysis was used to investigate the association of patient satisfaction metrics with neurosurgeon quality, as measured by their individual rate of mortality and average length-of-stay (LOS).
Results: Overall, 166,365 patients underwent neurosurgical procedures during the study. Using a propensity adjusted multivariable regression analysis we demonstrated that undergoing neurosurgical operations in hospitals with a greater percentage of patient-assigned “high” score were associated with higher chance of being treated by a physician with superior performance in terms of mortality (OR 1.90; 95% CI, 1.86 to 1.95), and a higher chance of being treated by a physician with superior performance in terms of length-of-stay (LOS) (OR 1.24; 95% CI, 1.21 to 1.27). Similar associations were identified for hospitals with a higher percentage of patients, who claimed they would recommend these institutions to others.
Conclusions: Merging a comprehensive all-payer cohort of neurosurgery patients in New York State with data from the CMS Hospital Compare website, we observed an association of superior hospital-level patient satisfaction measures with the objective performance of individual neurosurgeons in the corresponding hospitals.
Patient Care: The present analysis demonstrated an association of superior physician performance with subjective patient satisfaction Hospital Compare metrics. It is unlikely that there is a direct correlation between the two variables. However, this association likely reflects a general “culture of excellence” in institutions with a focus on patient satisfaction. Such facilities are likely to also attract the highest performing physicians. In this regard, patient satisfaction must be viewed as an essential but not sole indicator of surgical quality. Furthermore, the association between subjective and objective surgical outcomes may vary significantly between disease states, patient populations and specific procedures.
Learning Objectives: By the conclusion of this session, participants should be able to:
Identify whether publicly reported benchmarks correlate with the quality of physicians and institutions for neurosurgery patients
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