The Spine Journal published a new study examining the gap between the best and worst performing hospitals for 90-day spine surgery episodes of care.
The study authors examined patients from hospitals that had at least 20 elective cervical and 20 elective non-cervical fusions recorded in the Medicare limited database from 2012 to 2014. The study authors examined more than 500 candidate risk factors to develop logistic regression models predicting adverse outcomes 90 days post discharge.
There were 874 hospitals that met the criteria covering around 167,395 cases. The study authors found:
1. Around 16 percent of the cervical fusion patients and 15 percent of the non-cervical fusion patients had at least one adverse outcome. Overall, 15.2 percent of the patients reported adverse outcomes.
2. Fifty-four of the hospitals — 6.2 percent — reported z-scores at 2.0 or better than predicted. The median risk adjusted adverse outcome rate was 9.2 percent.
3. Seventy-five hospitals—8.6 percent—reported being 2.0 z-scores poorer than predicted. The median risk-adjusted adverse outcome rate was 23.2 percent.
4. The study authors concluded, "The difference between best and poorest performing hospitals identifies the need for facilities to know their outcomes of care, and to benchmark those results to national standards to identify the opportunities for care improvement."
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