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Quality measures improve outcomes more than hospital volume alone
Date:5/20/2009

A new study by researchers at the University of California, San Francisco and Baystate Medical Center at Tufts University in Massachusetts concludes that patients facing coronary artery bypass surgery should, as a first priority, select a medical facility that has the highest adherence to quality standards.

The research team sought to determine how volume among individual surgeons, volume differences between hospitals, and differences in quality of care might influence outcomes following coronary artery bypass surgery. According to the researchers, care from high-volume centers or surgeons has been associated with better outcomes post-operatively, but how volume and quality of care were related has not been well understood.

"You could go to the busiest doctor, as many people do," said study author Andrew Auerbach, MD, MPH, associate clinical professor of medicine at UCSF and director of research for the Division of Hospital Medicine. "But how busy the surgeon is may not matter as much as his or her team's adherence to quality measures."

The study, "Shop for Quality or Volume? Volume, Quality, and Outcomes of Coronary Artery Bypass Surgery," is published in the May 19, 2009 edition of Annals of Internal Medicine.

The study examined data on 81,289 patients cared for by 1,451 surgeons at 164 hospitals in the United States participating in Perspective, a voluntary, fee-supported database that measures quality and health care utilization.

"Conventional wisdom suggests that patients in need of surgery should seek care from hospitals and surgeons that perform the procedure oftenpractice makes perfect," said study senior author Peter Lindenauer, MD, MSc, director of the Center for Quality of Care Research at Baystate Medical Center and associate professor of medicine at Tufts University School of Medicine.

Very little is known about what makes high volume centers or surgeons more successful, the research
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Contact: Kirsten Michener
kmichener@pubaff.ucsf.edu
415-476-2557
University of California - San Francisco
Source:Eurekalert

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