Surgical Mortality as an Indicator of Hospital Quality

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Abstract
Patients and policy makers increasingly use rates of surgical mortality to assess hospital performance. New York and Pennsylvania have long-standing systems for tracking and publicly reporting risk-adjusted mortality rates after cardiac surgery1,2; California and New Jersey have more recently adopted this approach.3,4 The Leapfrog Group, a large coalition of employers and purchasers, has made surgical mortality rates one of the criteria for "evidence-based referral" for cardiac procedures.5 As part of its broader efforts to develop a core set of quality indicators, the Agency for Healthcare Research and Quality (AHRQ) has recently endorsed the use of surgical mortality rates for 7 surgical procedures including repair of abdominal aortic aneurysm, esophageal resection, and hip replacement.6

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