Hospital risk-adjusted margin positivity rate is quality metric

Hospital risk-adjusted margin positivity rate is quality metric

(HealthDay)—Hospital risk-adjusted margin positivity rate (RAMP) can identify performance-based outliers and represents a rectal cancer surgery quality metric, according to a study published online Aug. 4 in the Journal of Clinical Oncology.

Nader N. Massarweh, M.D., from the University of Texas M.D. Anderson Cancer Center in Houston, and colleagues conducted an observational cohort study of 32,354 patients with within the National Cancer Data Base (2003 to 2005), treated at 1,349 hospitals. Using standard observed-to-expected methodology, hospital performance was classified as low outlier (better than expected), high outlier (worse than expected), or non-RAMP outlier.

The researchers observed significant correlations for various structural (academic status and volume), process (pathologic nodal evaluation and neoadjuvant radiation therapy use), and outcome (sphincter preservation, readmission, and 30-day postoperative mortality) measures with outlier status. Low outliers had better five-year overall survival than high outliers and nonoutliers (79.9 versus 64.9 and 68.9 percent, respectively; P < 0.01). The risk of death was lower at low outliers versus high outliers and nonoutliers (hazard ratios, 0.61 and 0.69, respectively). A higher risk of death was seen at high outliers versus nonoutliers (hazard ratio, 1.12).

"Hospital RAMP outlier status is a rectal cancer surgery composite metric that reliably captures hospital quality across all levels of care and could be integrated into existing quality improvement initiatives for ," the authors write.


Explore further

Pre-op MRI of margins predicts rectal cancer outcomes

More information: Abstract
Full Text (subscription or payment may be required)
Editorial
Journal information: Journal of Clinical Oncology

Copyright © 2014 HealthDay. All rights reserved.

Citation: Hospital risk-adjusted margin positivity rate is quality metric (2014, August 7) retrieved 22 October 2019 from https://medicalxpress.com/news/2014-08-hospital-risk-adjusted-margin-positivity-quality.html
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.
 shares

Feedback to editors

User comments

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