PMID- 31069903
OWN - NLM
STAT- MEDLINE
DCOM- 20210728
LR  - 20220412
IS  - 1365-2753 (Electronic)
IS  - 1356-1294 (Print)
IS  - 1356-1294 (Linking)
VI  - 26
IP  - 1
DP  - 2020 Feb
TI  - Assessing whether cancer stage is needed to evaluate measures of hospital 
      surgical performance.
PG  - 66-71
LID - 10.1111/jep.13168 [doi]
AB  - RATIONAL, AIMS, AND OBJECTIVES: While public reports of hospital-level surgical 
      quality measures are becoming increasingly common in health care, a comprehensive 
      national assessment of surgical quality across multiple cancer sites has yet to 
      be developed. Fee-for-service (FFS) Medicare claims present a potential resource 
      from which to measure outcomes following cancer surgery given the national scope 
      of patients and providers. However, due to the administrative nature of the data, 
      clinical cancer information such as stage is not recorded. Leveraging the 
      Surveillance, Epidemiology, and End Results (SEER) registry linked to FFS 
      Medicare claims to analyse outcomes for patients whom we ultimately know stage 
      information, we determined whether Medicare claims are suitable for measuring 
      provider quality following cancer surgery by assessing the extent to which the 
      lack of stage information modifies assessments of provider performance. METHODS: 
      We identified patients aged 66 and older undergoing cancer surgery between 2011 
      and 2013 from SEER-Medicare. We compared the changes in the risk-standardized 
      rates (RSRs), decile rankings, and c-statistics with and without risk adjustment 
      for cancer stage for three measures of hospital performance: 30-day mortality, 
      surgical complications, and unplanned readmissions. RESULTS: The RSR changed by 
      at most 11.4% for mortality and by less than 4% for complications and 
      readmissions, indicating that measures of hospital performance were stable with 
      and without adjustment for stage. The relative performance of hospitals was also 
      stable, as demonstrated by fewer than 20% of hospitals changing decile rank. The 
      c-statistic declined by less than 2% across all measures, indicating that model 
      fit was not substantially worsened without this information. CONCLUSION: These 
      findings support the use of FFS Medicare claims for hospital-level analyses of 
      short-term outcomes following cancer surgery. Quality reporting based on these 
      analyses can be used to help patients choose among hospitals and for evaluating 
      policies to improve surgical cancer care.
CI  - (c) 2019 John Wiley & Sons, Ltd.
FAU - Lavery, Jessica A
AU  - Lavery JA
AUID- ORCID: 0000-0002-2746-5647
AD  - Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, 
      New York, New York.
AD  - Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer 
      Center, New York, New York.
FAU - Lipitz-Snyderman, Allison
AU  - Lipitz-Snyderman A
AD  - Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, 
      New York, New York.
FAU - Li, Diane G
AU  - Li DG
AD  - Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, 
      New York, New York.
FAU - Bach, Peter B
AU  - Bach PB
AD  - Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, 
      New York, New York.
FAU - Panageas, Katherine S
AU  - Panageas KS
AD  - Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer 
      Center, New York, New York.
LA  - eng
GR  - P30 CA008748/CA/NCI NIH HHS/United States
PT  - Journal Article
DEP - 20190509
PL  - England
TA  - J Eval Clin Pract
JT  - Journal of evaluation in clinical practice
JID - 9609066
SB  - IM
MH  - Aged
MH  - Fee-for-Service Plans
MH  - Hospitals
MH  - Humans
MH  - *Medicare
MH  - Neoplasm Staging
MH  - *Neoplasms/surgery
MH  - Risk Adjustment
MH  - United States
PMC - PMC6842027
MID - NIHMS1025652
OTO - NOTNLM
OT  - Medicare claims
OT  - cancer stage
OT  - hospital performance
OT  - quality measurement
EDAT- 2019/05/10 06:00
MHDA- 2021/07/29 06:00
PMCR- 2021/02/01
CRDT- 2019/05/10 06:00
PHST- 2018/12/03 00:00 [received]
PHST- 2019/04/12 00:00 [revised]
PHST- 2019/04/14 00:00 [accepted]
PHST- 2019/05/10 06:00 [pubmed]
PHST- 2021/07/29 06:00 [medline]
PHST- 2019/05/10 06:00 [entrez]
PHST- 2021/02/01 00:00 [pmc-release]
AID - 10.1111/jep.13168 [doi]
PST - ppublish
SO  - J Eval Clin Pract. 2020 Feb;26(1):66-71. doi: 10.1111/jep.13168. Epub 2019 May 9.