No Association Between Hospital-Reported Perioperative Venous Thromboembolism Prophylaxis and Outcome Rates in Publicly Reported Data

Venous thromboembolism (VTE), consisting of deep vein thrombosis (DVT) and pulmonary embolism, is an important cause of postoperative mortality and long-term morbidity. Because many events are preventable, VTE prophylaxis performance and postoperative VTE are used as measures of hospital quality of care and patient safety. Two such metrics are reported on the Centers for Medicare & Medicaid Services Hospital Compare website (http://www.medicare.gov/hospitalcompare/search.html) with the stated goal of helping consumers make decisions about where to receive their health care.

The Surgical Care Improvement Project (SCIP) VTE-2, a process measure, captures the percentage of a hospital’s surgical patients who received any VTE prophylaxis within 24 hours of surgery. Previous studies have shown that performance on the SCIP VTE-2 measure is not associated with VTE among Medicare patients in 6 high-risk surgical procedures,¹ nor with outcomes in a Veterans Affairs cohort.² In October 2011, Hospital Compare made additional VTE outcomes data available to consumers. We hypothesized that there is no association between the process measure (SCIP VTE-2) and the outcome (Agency for Healthcare Research and Quality Patient Safety Indicator [PSI]–12, a risk-adjusted postoperative VTE rate based on administrative data).