Variation in bowel reoperation rates prompts call for better quality measures

August 17, 2011

There is a large variation in unplanned reoperation rates after colorectal surgery in English NHS hospitals, finds a study published in the British Medical Journal today.

As such, researchers suggest that reoperation rates could be used alongside other to help improve surgical performance on a national scale.

Variation in surgical performance is becoming increasingly unacceptable to clinicians, healthcare managers, commissioners, and . Death after surgery is currently one of the most widely recognised indicators of quality, but in isolation, its use is limited. To better measure performance and improve standards, a range of indicators is needed.

So researchers at Imperial College London used Hospital Episode Statistics (a dataset covering the entire English NHS) to describe national reoperation rates after colorectal surgery and to investigate the feasibility of using reoperation as a quality indicator.

Their findings are based on data for 246,469 patients in 175 English hospital trusts who underwent colorectal surgery for the first time between 1 April 2000 and 31 March 2008.

A total of 15,986 (6.5%) patients needed further surgery (reoperation).

Emergency patients experienced slightly higher reoperation rates than elective patients. , and those with or other existing conditions, were also more likely to need further unplanned surgery.

The researchers found substantial variation in reoperation rates among hospital trusts and individual surgeons.

For instance, there was a fivefold difference in highest and lowest reoperation rates after (14.9% v 2.8%) among trusts performing more than 500 procedures, and a threefold difference in reoperation rates in trusts performing more than 2,500 procedures during the study period (11.5% v 3.7%).

This study supports the feasibility of using reoperation rate as a quality indicator derived from routinely collected data across a range of surgical specialties, say the authors, and they suggest that "reoperation rates, along with existing quality indicators such as mortality, could offer a powerful means of checking quality of surgical care."

In an accompanying editorial, Arden Morris, Associate Professor of at the University of Michigan, welcomes the study, but argues that measuring quality is only the first step in the more important goal of improving quality.

She says that a call for mandatory reporting of reoperation rates "is unlikely to result in a change in surgical technique" and he urges researchers "to propose mechanisms by which their data can be used for quality improvement – by individual providers, hospitals, and policy makers."

Related Stories

Recommended for you

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

Team eradicates hepatitis C in 10 patients following lifesaving transplants from infected donors

April 30, 2017
Ten patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving kidney transplants from deceased donors who were infected with the disease. The findings point to new strategies for increasing ...

'bench to bedside to bench': Scientists call for closer basic-clinical collaborations

March 24, 2017
In the era of genome sequencing, it's time to update the old "bench-to-bedside" shorthand for how basic research discoveries inform clinical practice, researchers from The Jackson Laboratory (JAX), National Human Genome Research ...

The ethics of tracking athletes' biometric data

January 18, 2017
(Medical Xpress)—Whether it is a FitBit or a heart rate monitor, biometric technologies have become household devices. Professional sports leagues use some of the most technologically advanced biodata tracking systems to ...

Financial ties between researchers and drug industry linked to positive trial results

January 18, 2017
Financial ties between researchers and companies that make the drugs they are studying are independently associated with positive trial results, suggesting bias in the evidence base, concludes a study published by The BMJ ...

Best of Last Year – The top Medical Xpress articles of 2016

December 23, 2016
(Medical Xpress)—It was a big year for research involving overall health issues, starting with a team led by researchers at the UNC School of Medicine and the National Institutes of Health who unearthed more evidence that ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.