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June 2016

A Novel Approach to Global Benchmarking of Risk-Adjusted Surgical OutcomesBeyond Perioperative Mortality Rate

Author Affiliations
  • 1Department of Surgery, University of Cape Town, Cape Town, South Africa
  • 2Codman Center for Clinical Effectiveness in Surgery, Department of General Surgery, Massachusetts General Hospital, Boston
  • 3Harvard Medical School, Boston, Massachusetts
JAMA Surg. 2016;151(6):501-502. doi:10.1001/jamasurg.2016.0091

The report by the Lancet Commission on Global Surgery recently highlighted 6 core measurable indicators essential to achieving the goal of universal access to safe, affordable surgical and anesthesia care.1 One indicator, perioperative mortality, was identified as crucial for monitoring progress toward this goal. However, adverse events, including postoperative mortality, are an inevitable consequence of major surgery and some adverse events may be expected or even acceptable. Without case-mix adjustment and taking the heterogeneity of surgical patients and procedures into account, hospitals that manage sicker patients would appear to have worse outcomes. Reporting perioperative mortality alone offers little in the way of meaningful comparisons or identifying opportunities for quality improvement.

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