Defining quality is difficult in all walks of life, particularly in medicine and especially in surgery. However, the quality of patient care is a hot topic among physicians, hospital administrators, policy makers, insurance carriers, media analysts, and, most importantly, patients. Quality measures in surgery, such as costs, margin status, lymph node harvest, length of stay, morbidity, mortality, and readmission rates, are easy to measure but are quite complex and heavily influenced by patient, disease, surgeon, and hospital factors. Yet, it is these measures that may prove to govern patient flow, resource allocation, and reimbursement in the future. In this issue of JAMA Surgery, Hyder et al1 report on 30-day readmission rates following pancreatoduodenectomy (PD) using Surveillance, Epidemiology, and End Results (SEER)–linked Medicare data. In their study, they take into account not only patient- and disease-related factors, but also surgeon and hospital volume in an effort to “quantitatively assess the relative contributions of [these factors] on readmission following PD.”
Bloomston M. Readmissions Following Pancreatoduodenectomy: It’s When Things Don’t Go Well That Experienced Pancreatic Surgeons Earn Their Keep. JAMA Surg. 2013;148(12):1102. doi:10.1001/jamasurg.2013.2528
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