Surgical Outcomes Vary Widely Across Hospitals

Survival rates for high-risk surgical procedures vary significantly hospital-to-hospital, according to the findings of a new report from The Leapfrog Group and Castlight Health.

The report focused on 4 specific procedures that are both common and high-risk: abdominal aortic aneurysm (AAA) repair, aortic valve replacement (AVR), pancreatectomy, and esophagectomy. The report includes predicted survival rates, by hospital, for each type of surgery.

“The frequency of these high-risk surgical procedures is expected to increase as the US population ages, making the report findings that much more important,” Jennifer Schneider, MD, MS, chief medical officer for Castlight Health, said in a statement. “Beyond the devastating personal and emotional toll of a poor outcome on patients and providers, there is the notable financial burden on the US health care system when less-than-optimal care is delivered. By every measure, these findings warrant attention and immediate action.”

Leapfrog found that the variation in the survival rate for a pancreatectomies varies 19 percentage points across hospitals, with predicted survival rates ranging from 81% to 100%. The survival rate for AAA repair varies 13 percentage points from 86% to 99%; for AVR the survival rate varies 5 percentage points from 92% to 97%; and for esophagectomy the survival rate varies 10 percentage points from 88% to 98%.

The predicted survival rate is calculated using the number of patients who had the surgery at a given hospital and the number of those who died after having the procedure at that hospital. The report provided additional steps for hospitals and stakeholders to take to ensure patients receive the best care:

• Hospitals with low predicted survival rates should learn from those who achieved high standards of care to work toward better surgical outcomes.
• Employers should encourage employees to choose hospitals that provide the highest levels of surgical care.
• Patients and families should research the hospital’s quality of care and survival rates before choosing a hospital for their procedure.

“We strongly encourage consumers to examine their local hospitals’ performance on these high-risk procedures, as the data on survival rates enables patients to gauge their likelihood of surviving each procedure at a given hospital,” Leah Binder, president and chief executive officer of Leapfrog, said.