Risk-adjusted analysis of surgeon performance: a 1-year study.
Br J Surg
; 82(3): 408-11, 1995 Mar.
Article
em En
| MEDLINE
| ID: mdl-7796028
ABSTRACT
A 1-year prospective analysis was undertaken of all non-day-case general surgery in a district general hospital. Using the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) scoring system 3004 patients were assessed. From the predictions of mortality and morbidity so obtained, a quality measure, the ratio of observed to expected numbers of deaths and complications (OE ratio) was determined for each surgeon, both overall and within specialty zones. The present study demonstrates the serious hazard in using 'raw' uncorrected mortality and morbidity statistics to compare surgeon performance. Mortality rates varied from 1.0 to 4.9 per cent whereas OE ratios ranged from 0.83 to 1.06; morbidity rates varied from 5.3 to 12.6 per cent with OE ratios 0.86-1.02. Great misunderstanding may result from the publication of surgeon or hospital 'league tables'. The present study demonstrates a technique that might allow surgeon performance to be monitored adequately and accurately.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Prática Profissional
/
Cirurgia Geral
/
Mortalidade Hospitalar
/
Corpo Clínico Hospitalar
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Br J Surg
Ano de publicação:
1995
Tipo de documento:
Article