Does voluntary reporting bias hospital quality rankings?

The Journal of Surgical Research
Amir A GhaferiJustin B Dimick

Abstract

The Leapfrog Group, a large consortium of private payers, collects voluntary, self-reported quality information from hospitals for several different procedures. Critics argue that voluntary reporting leads to over-representation of high quality hospitals. We used data from 1169 hospitals participating in the 2008 Leapfrog Survey for six high-risk procedures. We first ranked the hospitals who voluntarily submitted data to Leapfrog using a composite quality measure (a combination of mortality and hospital volume). We then created a similar set of rankings for a national sample of hospitals from the 2006 Nationwide Inpatient Sample (NIS). Next, we created four groups (quartiles) of hospital performance based on the national sample of hospitals. Finally, we compared the Leapfrog hospitals with the national sample of hospitals. If voluntary reporting resulted in bias, we would expect the Leapfrog hospitals to cluster in the top quartiles for each procedure. The distribution of the Leapfrog hospitals within the NIS performance quartiles varied extensively across procedures. For abdominal aortic aneurysm repair and coronary artery bypass grafting, there was a clustering of hospitals in the two worst quartiles (64% and 65%, respectivel...Continue Reading

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Citations

Aug 31, 2010·Journal of the American College of Surgeons·Amir A GhaferiJustin B Dimick
Feb 27, 2010·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Alex Almoudaris, Omar Faiz
May 29, 2012·Journal of the American College of Surgeons·David C ChangMark A Talamini
Dec 8, 2010·The British Journal of Surgery·A M AlmoudarisO Faiz
Apr 15, 2014·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·D JegouUNKNOWN PROCARE
Mar 13, 2013·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Michael N NeussJoseph V Simone
Mar 21, 2018·Annals of Surgery·Sarah T WardAmir A Ghaferi
Nov 14, 2020·BMC Health Services Research·Elettra CariniMaria Lucia Specchia

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