Surgery Complications Decline 10% After Hospitals Share Data

Michigan hospitals cut surgical complications almost a tenth, reducing medical costs, by pooling data about practices that keep patients safer, a study found.

The portion of patients deemed ill following surgery fell to 9.7 percent after the information sharing, from 10.7 percent before, scientists said today in the Archives of Surgery. Sixteen institutions, led by the University of Michigan Health System, saved $13 million on cases of ventilator-associated pneumonia alone, the researchers said in a statement.

The program, which predated President Barack Obama’s effort to cut U.S. health expenses and improve care, gets competing institutions to determine which practices are effective at preventing surgical complications, said David Share, executive medical director for health-care quality at Detroit-based Blue Cross Blue Shield of Michigan, a not-for-profit insurer that paid the hospitals to collaborate.

“Complications are relatively rare, and any one hospital may not have enough data to see the links between processes and outcomes,” said Share, a study co-author, in a telephone interview. A specialist in public health and preventive medicine, Share is affiliated with the University of Michigan Health System, based in Ann Arbor.

The study involved more than 35,000 Michigan patients and focused on general and vascular surgeries from April 2005 through December 2007. The complications seen after April 2007, by which time the collaboration was expected to have effects, were compared with those that occurred earlier.

Fewer Infections

Complications reduced the most were blood infections, septic shock, prolonged ventilator use and cardiac arrest, according to the study.

For the same time periods, data from the National Surgical Quality Improvement Program, an initiative of the Chicago-based American College of Surgeons, showed no changes in the prevalence of complications for more than 280,000 patients who were treated at 126 non-Michigan hospitals, according to the report.

Under the Michigan program, Blue Cross Blue Shield reimburses hospitals for the “rigorous data collection necessary for the success of this kind of program,” and provides “a little extra reward to encourage their active participation,” Share said.

The collaboration now involves 34 institutions, mostly community hospitals, and they’re paid to review the records of all patients, not just Blue Cross members, Share said.

“If the system was adopted nationally, not just in Michigan, I think you would find a greatly accelerated pace of surgical quality improvement,” said Darrell Campbell, the lead author and a surgeon, in a statement. Campbell is chief of clinical affairs in the University of Michigan system.

Besides Blue Cross Blue Shield of Michigan, the American Surgical Association Foundation, based in Beverly, Massachusetts, also supported the study.

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