Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Lancet. 2013 Nov 16;382(9905):1674-7. doi: 10.1016/S0140-6736(13)61491-9. Epub 2013 Jul 5.
The English National Health Service published outcome information for individual surgeons for ten specialties in June, 2013. We looked at whether individual surgeons do sufficient numbers of procedures to be able to reliably identify those with poor performance. For some specialties, the number of procedures that a surgeon does each year is low and, as a result, the chance of identifying a surgeon with increased mortality rates is also low. Therefore, public reporting of individual surgeons' outcomes could lead to false complacency. We recommend use of outcomes that are fairly frequent, considering the hospital as the unit of reporting when numbers are low, and avoiding interpretation of no evidence of poor performance as evidence of acceptable performance.
2013 年 6 月,英国国家医疗服务体系公布了 10 个专业领域的外科医生个人手术结果信息。我们研究了外科医生完成的手术数量是否足以可靠地识别表现不佳的医生。在某些专业中,外科医生每年完成的手术数量较少,因此,发现死亡率增加的外科医生的机会也较低。因此,外科医生个人手术结果的公开报告可能会导致虚假的自满情绪。我们建议在数量较少时,将医院作为报告单位,使用较为常见的结果,避免将无不良绩效证据解释为可接受的绩效证据。