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Study Evaluates Variation in Surgical Outcomes Across Networks of the Highest-Rated US Hospitals

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A study published in JAMA Surgery sought to evaluate the extent to which surgical outcomes varied across hospitals that are affiliated with the 2018 US News & World Report Honor Roll hospitals. In this population-based study of 87 hospitals that participated in 1 of 16 networks that are affiliated with US News & World Report Honor Roll hospitals used data from Medicare beneficiaries who were undergoing colectomy, coronary artery bypass graft, or hip replacement between 2005 and 2014 to evaluate the variation in risk-adjusted surgical outcomes at Honor Roll and affiliated hospitals within and across networks. The data were analyzed between April 20, 2018, and June 25, 2018. The study found outcomes were not consistently better at Honor Roll hospitals. Within networks, the risk-adjusted rates for all outcomes varied widely across affiliated hospitals; for example, the differences in failure to rescue varied by 1.1-fold in some networks to as much as 4.9-fold in others. The study concluded surgical outcomes vary widely across hospitals affiliated with the US News & World Report Honor Roll hospitals. Public reporting mechanisms should provide patients with information on the quality of all network-affiliated hospitals. Networks should monitor variations in outcomes to characterize and improve the extent to which a uniform standard of care is being delivered.

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