Kyle H. Sheetz|Seth A. Waits|Micah E. Girotti|Darrell A. Campbell|Michael J. Englesbe
Patients' Perspectives of Care and Surgical Outcomes in Michigan
University of Michigan–Ann Arbor|A. Alfred Taubman Health Care Center|Blue Cross Blue Shield of Michigan Foundation|University of Michigan–Ann Arbor|A. Alfred Taubman Health Care Center|Blue Cross Blue Shield of Michigan Foundation|University of Michigan–Ann Arbor|A. Alfred Taubman Health Care Center|Blue Cross Blue Shield of Michigan Foundation|University of Michigan–Ann Arbor|A. Alfred Taubman Health Care Center|Blue Cross Blue Shield of Michigan Foundation|University of Michigan–Ann Arbor|A. Alfred Taubman Health Care Center|Blue Cross Blue Shield of Michigan Foundation
brief objective determine relationship postoperative morbidity mortality patients perspectives care background priorities health care quality research shifting place greater emphasis patientcentered outcomes whether patients perspectives care correlate surgical outcomes remains unclear design retrospective cohort study methods using data michigan surgical quality collaborative clinical registry 20082012 identified 41833 patients undergoing major elective general vascular surgery exposure variables hospital consumer assessment healthcare providers systems hcahps total base scores derived hospital valuebased purchasing patient experience care domain using multilevel mixedeffects logistic regression models adjusted hospitals rates morbidity mortality patient comorbidities case mix stratified reporting outcomes quintiles hospitals total base scores results riskadjusted morbidity 136286 varied widely across hospitals significant differences riskadjusted morbidity rates hospitals lowest highest hcahps total scores 245 vs 202 p 0312 hcahps base score quantifies sustained achievement improvement patients perspectives care associated reduction postoperative morbidity study period despite overall decrease 25 centers observed similar relationship hcahps total base scores postoperative mortality conclusions relevance patients perspectives care correlate incidence morbidity mortality major surgery improving patients perspectives objective outcomes may require separate initiatives surgeons michigan patientcentered outcomes growing importance stratified michigan hospitals using hcahps survey patientsperspectives care assessed incidence postoperative morbiditymortality patientsperspectives correlate objective surgical outcomes calling question ability incentivize surgical quality improvement