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疝手术的在线外科医生评分与手术结果:一项美国疝学会质量协作分析

Online Surgeon Ratings and Outcomes in Hernia Surgery: An Americas Hernia Society Quality Collaborative Analysis.

作者信息

Haskins Ivy N, Krpata David M, Rosen Michael J, Perez Arielle J, Tastaldi Luciano, Butler Robert S, Rosenblatt Steven, Prabhu Ajita S

机构信息

Comprehensive Hernia Center, Department of General Surgery, The Cleveland Clinic Foundation, Cleveland, OH.

Department of Quantitative Health Sciences, Lerner Research Institute, The Cleveland Clinic Foundation, Cleveland, OH.

出版信息

J Am Coll Surg. 2017 Nov;225(5):582-589. doi: 10.1016/j.jamcollsurg.2017.08.007. Epub 2017 Aug 31.

Abstract

BACKGROUND

Online surgeon ratings are viewed as a measure of physician quality by some consumers. Nevertheless, the correlation between online surgeon ratings and surgeon quality metrics remains unknown. The purpose of this study was to investigate the association between online surgeon ratings and hernia-specific quality metrics.

STUDY DESIGN

The Americas Hernia Society Quality Collaborative (AHSQC) is recognized by the Centers for Medicaid and Medicare as a Quality Clinical Data Registry (QCDR) that reports risk-adjusted quality metrics for hernia surgeons. All surgeons who input at least 10 patients into the AHSQC and had both a HealthGrades.com and Vitals.com rating were included in the analysis. The association of surgeons' average, risk-adjusted QCDR quality score with their online ratings was investigated using a linear regression model.

RESULTS

A total of 70 surgeons met inclusion criteria. The median number of evaluations each surgeon received on HealthGrades.com was 7; the median number of evaluations each surgeon received on Vitals.com was 3. There was a statistically significant correlation between the ratings surgeons received on HealthGrades.com and those that they received on Vitals.com (p < 0.0001). However, there was no correlation between surgeon ratings on either HealthGrades.com or Vitals.com and surgeon QCDR quality scores (p = 0.37 and p = 0.18, respectively).

CONCLUSIONS

Online physician rating systems correlate with one another, but they do not accurately reflect physician quality. The development of specialty-specific, risk-adjusted quality measures and appropriate public dissemination of this information may help patients make more informed decisions about their health care.

摘要

背景

一些消费者将在线外科医生评分视为衡量医生质量的指标。然而,在线外科医生评分与外科医生质量指标之间的相关性仍然未知。本研究的目的是调查在线外科医生评分与疝气特定质量指标之间的关联。

研究设计

美国疝气协会质量协作组织(AHSQC)被医疗保险和医疗补助服务中心认可为质量临床数据登记处(QCDR),该登记处报告疝气外科医生的风险调整后质量指标。所有向AHSQC输入至少10例患者信息且在HealthGrades.com和Vitals.com上均有评分的外科医生都纳入分析。使用线性回归模型研究外科医生的平均风险调整后QCDR质量得分与其在线评分之间的关联。

结果

共有70名外科医生符合纳入标准。每位外科医生在HealthGrades.com上收到的评估中位数为7次;在Vitals.com上收到的评估中位数为3次。外科医生在HealthGrades.com上获得的评分与在Vitals.com上获得的评分之间存在统计学显著相关性(p < 0.0001)。然而,外科医生在HealthGrades.com或Vitals.com上的评分与外科医生QCDR质量得分之间均无相关性(分别为p = 0.37和p = 0.18)。

结论

在线医生评分系统相互关联,但不能准确反映医生质量。制定特定专科、风险调整后的质量衡量标准并适当向公众传播这些信息,可能有助于患者就其医疗保健做出更明智的决策。

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