ABSTRACT
Since the 1990s, the use of quality measures in healthcare has grown exponentially. Practices must maintain current knowledge of measures that affect their clinicians locally and understand how assessment of these medical professionals affects the priorities and quality activities of practices and facilities. Because quality measures are increasingly used by hospital administrators, health plans, and payers, practices are being asked to shoulder the additional burdens of collecting and reporting data to various entities. Part of the solution to this increased burden often includes contracting with vendors and outside experts, as well as identifying effective local physician and practice champions.
Subject(s)
Anesthesiology/standards , Quality of Health Care/standards , Anesthesia/standards , Anesthesiology/statistics & numerical data , Anesthesiology/trends , Documentation , Humans , Quality of Health Care/statistics & numerical data , Quality of Health Care/trends , Registries , United StatesABSTRACT
BACKGROUND: The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD) has been successfully linked to the Centers for Medicare and Medicaid (CMS) Medicare database, thereby facilitating comparative effectiveness research and providing information about long-term follow-up and cost. The present study uses this link to determine contemporary completeness, penetration, and representativeness of the STS ACSD. METHODS: Using variables common to both STS and CMS databases, STS operations were linked to CMS data for all CMS coronary artery bypass graft (CABG) surgery hospitalizations discharged between 2000 and 2012, inclusive. For each CMS CABG hospitalization, it was determined whether a matching STS record existed. RESULTS: Center-level penetration (number of CMS sites with at least one matched STS participant divided by the total number of CMS CABG sites) increased from 45% in 2000 to 90% in 2012. In 2012, 973 of 1,081 CMS CABG sites (90%) were linked to an STS site. Patient-level penetration (number of CMS CABG hospitalizations done at STS sites divided by the total number of CMS CABG hospitalizations) increased from 51% in 2000 to 94% in 2012. In 2012, 71,634 of 76,072 CMS CABG hospitalizations (94%) occurred at an STS site. Completeness of case inclusion at STS sites (number of CMS CABG cases at STS sites linked to STS records divided by the total number of CMS CABG cases at STS sites) increased from 88% in 2000 to 98% in 2012. In 2012, 69,213 of 70,932 CMS CABG hospitalizations at STS sites (98%) were linked to an STS record. CONCLUSIONS: Linkage of STS and CMS databases demonstrates high and increasing penetration and completeness of the STS database. Linking STS and CMS data facilitates studying long-term outcomes and costs of cardiothoracic surgery.
Subject(s)
Coronary Artery Bypass/statistics & numerical data , Models, Statistical , Societies, Medical/statistics & numerical data , Thoracic Surgery/statistics & numerical data , Aged , Coronary Artery Bypass/economics , Coronary Artery Disease/economics , Coronary Artery Disease/surgery , Costs and Cost Analysis , Female , Follow-Up Studies , Hospitalization/trends , Humans , Male , Medicaid/economics , Medicare/economics , Retrospective Studies , Time Factors , United StatesABSTRACT
In July of 2011, the American Society of Plastic Surgeons Executive Committee approved the Venous Thromboembolism Task Force Report. The report includes a summary of the scientific literature relevant to venous thromboembolism and plastic surgery along with five evidence-based recommendations. The recommendations are divided into two sections: risk stratification and prevention. The risk stratification recommendations are based on the 2005 Caprini Risk Assessment Module, which has been validated in the scientific literature as an effective tool for risk-stratifying plastic and reconstructive surgery patients based on individual risk factors for 60-day venous thromboembolism. The three prophylaxis recommendations are dependent on an individual patient's 2005 Caprini Risk Assessment Module score.
Subject(s)
Advisory Committees , Plastic Surgery Procedures/adverse effects , Postoperative Complications , Risk Assessment/methods , Societies, Medical , Surgery, Plastic , Venous Thromboembolism , Animals , Humans , Incidence , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Complications/prevention & control , United States/epidemiology , Venous Thromboembolism/epidemiology , Venous Thromboembolism/etiology , Venous Thromboembolism/prevention & controlABSTRACT
Evidence-based medicine is defined as the conscientious, explicit, and judicious use of current best evidence, combined with individual clinical expertise and patient preferences and values, in making decisions about the care of individual patients. In an effort to emphasize the importance of evidence-based medicine in plastic surgery, the American Society of Plastic Surgeons and Plastic and Reconstructive Surgery have launched an initiative to improve the understanding of evidence-based medicine concepts and provide tools for implementing evidence-based medicine in practice. Through a series of special articles aimed at educating plastic surgeons, the authors' hope is that readers will be compelled to learn more about evidence-based medicine and incorporate its principles into their own practices. As the first of the series, this article provides a brief overview of the evolution, current application, and practice of evidence-based medicine.
