Key result
CMS 1-star hospitals had higher 30-day postoperative mortality than 5-star hospitals (6.80% vs 4.93%; adjusted OR 1.86, 95% CI 1.73-2.00), though wide variation existed within each star rating.
Why the study?
Despite widespread use to guide patients, it remained unknown whether CMS hospital star ratings are a reliable measure of hospital surgical quality.
Does the CMS hospital star rating reliably reflect 30-day postoperative mortality, serious complications, and readmission rates in Medicare beneficiaries undergoing common surgeries?
Population
1 898 829 fee-for-service Medicare beneficiaries aged 66 to 99 years undergoing 5 surgical procedures at 3240 hospitals
Comparison
Hospitals compared across CMS hospital star ratings
Design
Cohort study
Follow-up
30 days
Authors
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CMS star ratings associate modestly with surgical outcomes yet overlap widely within ratings; leaves open their reliability for guiding patients to optimal hospitals.
Cohort (n=1,898,829)
Yes
Does the CMS hospital star rating reliably reflect 30-day postoperative mortality, serious complications, and readmission rates in Medicare beneficiaries undergoing common surgeries?
Odds Ratio: 1.86 (95% CI 1.73–2)
Absolute Event Rate: 6.8% vs 4.93%
Although higher CMS hospital star ratings are associated with better average surgical outcomes, wide intra-rating variation limits their reliability as a definitive measure of surgical quality for individual hospitals.
Díaz et al. (2024) conducted a cohort in Surgical procedures (colectomy, CABG, cholecystectomy, appendectomy, incisional hernia repair) (n=1,898,829). CMS hospital star rating (1-star) vs. CMS hospital star rating (5-star) was evaluated on Risk- and reliability-adjusted 30-day postoperative mortality (adjusted OR 1.86, 95% CI 1.73-2.00). CMS 1-star hospitals had higher 30-day postoperative mortality than 5-star hospitals (6.80% vs 4.93%; adjusted OR 1.86, 95% CI 1.73-2.00), though wide variation existed within each star rating.
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