Measures of surgical quality: what will patients know by 2005?

Rationale, Aims And Objectives: Many objective measures rating quality of doctors, hospitals, and medical groups are publicly reported. Surgical patients may have more opportunity to use quality measures than other types of patients to guide their choice of provider. If surgical patients are able to choose higher quality providers, overall surgical quality might increase.

Objective: To determine what procedure-specific measures of surgical quality are available to consumers facing surgery in California and what new measures will be available by 2005.

Methods: We searched for and surveyed organizations publicly reporting data on health care quality in California. We asked about current quality measures and new measures set for public release by 2005. Included measures had to be procedure-specific and results separated by hospital. The main outcome measures were the number of quality measures; conceptual aspect of quality measured; and type of risk-adjustment used.

Results: Eighteen organizations publicly report any health care quality measures in California. These organizations report 333 measures, of which 32 (10%) are procedure-specific measures of surgical quality. There is at least one quality measure for 21 different procedures; these procedures account for 14% of all major operations. Three new measures will be released by 2005.

Conclusions: Californians facing surgery have limited information regarding quality of their care; few new measures are planned. Eighty-six per cent of patients would find no quality measures related to planned procedures. Public release of performance data is unlikely to improve the quality of health care unless the number and comprehensiveness of measures increase dramatically.