Key result
Surgery at Magnet hospitals was not associated with higher odds of achieving a Textbook Outcome compared to non-Magnet centers for hepatectomy (OR 1.05; 95% CI 0.94-1.17) or pancreatectomy.
Why the study?
The relationship between hospital Magnet status recognition and postoperative outcomes after complex cancer surgery remains ill-defined.
Does surgery at Magnet hospitals improve Textbook Outcomes in Medicare beneficiaries undergoing hepato-pancreatic surgery for cancer?
Cohort (n=10,997)
Yes
Does surgery at Magnet hospitals improve Textbook Outcomes in Medicare beneficiaries undergoing hepato-pancreatic surgery for cancer?
Hospital Magnet designation is not an independent predictor of superior outcomes after hepato-pancreatic surgery; rather, nurse-to-bed ratio and procedural volume drive outcomes.
Answers are grounded in this paper and cite their sources.
Magnet status was not linked to higher textbook outcomes after HP cancer surgery; leaves open whether recognition identifies or improves surgical quality.
BACKGROUND: The relationship between hospital Magnet status recognition and postoperative outcomes following complex cancer surgery remains ill-defined. We sought to characterize Textbook Outcome (TO) rates among patients undergoing (HP) surgery for cancer in Magnet versus non-Magnet centers. METHODS: Medicare beneficiaries undergoing HP surgery between 2015 and 2017 were identified. The association of postoperative TO (no complications/extended length-of-stay/90-day mortality/90-day readmission) with Magnet designation was examined after adjusting for competing risk factors. RESULTS: Among 10,997 patients, 21.3% (n = 2337) patients underwent surgery at Magnet hospitals (non-Magnet centers: 78.7%, n = 8660). On multivariable analysis, patients undergoing HP surgery had comparable odds of achieving a TO at Magnet versus non-Magnet hospitals (hepatectomy: odds ratio [OR]: 1.05, 95% confidence interval [CI]: 0.94-1.17; pancreatectomy-OR: 0.88, 95% CI: 0.74-1.06). Patients treated at hospitals with a high nurse-to-bed ratio had higher odds of achieving a TO irrespective of whether they received surgery at Magnet (high vs. low nurse-to-bed ratio; OR: 1.38; 95% CI: 1.01-1.89) or non-Magnet centers (OR: 1.26; 95% CI: 1.10-1.45). Similarly, hospital HP volume was strongly associated with higher odds of TO following HP surgery in both Magnet (Leapfrog compliant vs. noncompliant; OR: 1.24, 95% CI: 1.06-1.44) and non-Magnet centers (OR: 1.18; 95% CI: 1.11-1.26). CONCLUSION: Hospital Magnet designation was not an independent factor of superior outcomes after HP surgery. Rather, hospital-level factors such as nurse-to-bed ratio and HP procedural volume drove outcomes.
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Mehta et al. (2021) conducted a cohort in Cancer requiring hepato-pancreatic surgery (n=10,997). Surgery at Magnet hospitals vs. Surgery at non-Magnet hospitals was evaluated on Textbook Outcome (no complications/extended length-of-stay/90-day mortality/90-day readmission) (OR 1.05, 95% CI 0.94-1.17). Surgery at Magnet hospitals was not associated with higher odds of achieving a Textbook Outcome compared to non-Magnet centers for hepatectomy (OR 1.05; 95% CI 0.94-1.17) or pancreatectomy.
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