About 30% of personal health care expenditures in the United States go towards hospital care, and the rate of growth in spending for hospital services has only recently leveled out after several years of increases following a half a decade of declining growth. Simultaneously, concerns about the quality of health care services have reached a crescendo with the Institute of Medicine's series of reports describing the problem of medical errors and the need for a complete restructuring of the health care system to improve the quality of care. Policymakers, employers, and consumers have made the quality of care in U.S. hospitals a top priority and have voiced the need to assess, monitor, track, and improve the quality of inpatient care.
Esophageal surgery is a rare procedure that requires technical proficiency; and errors in surgical technique or management may lead to clinically significant complications, such as sepsis, pneumonia, anastomotic breakdown, and death. Higher volumes have been associated with better outcomes, which represent better quality.
Note:
The following caveats were identified from the literature review for the "Esophageal Resection Volume" indicator:
- Proxyb: Indicator does not directly measure patient outcomes but an aspect of care that is associated with the outcome; thus, it is best used with other indicators that measure similar aspects of care.
- Easily manipulateda: Use of the indicator may create perverse incentives to improve performance on the indicator without truly improving quality of care.
Refer to the original measure documentation for further details.
a - The concern is theoretical or suggested, but no specific evidence was found in the literature.
b - Indicates that the concern has been demonstrated in the literature.
