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 cancer 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. Better processes of care may reduce mortality for esophageal resection, which represents better quality care.
Esophageal resection is a complex cancer surgery, and studies have noted that providers with higher volumes have lower mortality rates. This suggests that providers with higher volumes have some characteristics, either structurally or with regard to processes, that influence mortality.
Note:
The following caveats were identified from the literature review for the "Esophageal Resection Mortality Rate" indicator:
- Confounding biasa: Patient characteristics may substantially affect the performance of the indicator; risk adjustment is recommended.
- Unclear constructa: There is uncertainty or poor correlation with widely accepted process measures.
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.
