HM 820 - Class 11 (Quality)

Question 1

Is surgical skill related to years in practice or surgical volume?

Answer 1

Procedure volume

“Surgical skill was not related to years in bariatric surgery practice, status with respect to completion of a fellowship in advanced laparoscopy or bariatric surgery, or practice at a teaching or nonteaching hospital. Surgical skill was, however, strongly related to procedure volume.

Question 2

What is the “The Volume-Outcome Relationship”

Answer 2

Higher-volume providers tend to have better outcomes.

Question 3

What is process-of-care measures?

Question 4

Can process of care measures be manipulated by cream skimming?

Answer 4

No - Process-of-care measures cannot be manipulated by cream skimming.

Question 5

Outcomes of patients randomly assigned to top tier and middle tier physicians

Answer 5

Those treated by physicians from top-ranked programs had 10–25 percent less-expensive hospital stays.

○ The difference was mostly driven by diagnostic tests. “The lower ranked program tends to order more tests and takes longer to order them.”

○ No difference in actual health outcomes.

Question 6

Does the market “work” for hospitals - aka do high quality hospitals grow and do well over time

Answer 6

Yes? - Double check not clear from slides