Automated claims and pharmacy data identified indicators of postoperative infection in 27% of CABG patients, revealing significant variation between hospitals (19% to 36%, p<0.001) that persisted after adjustment.
Observational (n=1,953)
Yes
Can automated health plan data be used to assess and compare hospitals' risks of postoperative surgical site infection after coronary artery bypass surgery?
Automated claims and pharmacy data can be used to routinely monitor and compare postoperative infection indicators across hospitals after coronary artery bypass surgery.
p-value: p=<0.001
We determined if infection indicators were sufficiently consistent across health plans to allow comparison of hospitals' risks of infection after coronary artery bypass surgery. Three managed care organizations accounted for 90% of managed care in eastern Massachusetts, from October 1996 through March 1999. We searched their automated inpatient and outpatient claims and outpatient pharmacy dispensing files for indicator codes suggestive of postoperative surgical site infection. We reviewed full text medical records of patients with indicator codes to confirm infection status. We compared the hospital-specific proportions of cases with an indicator code, adjusting for health plan, age, sex, and chronic disease score. A total of 536 (27%) of 1,953 patients had infection indicators. Infection was confirmed in 79 (53%) of 149 reviewed records with adequate documentation. The proportion of patients with an indicator of infection varied significantly (p < 0.001) between hospitals (19% to 36%) and health plans (22% to 33%). The difference between hospitals persisted after adjustment for health plan and patients' age and sex. Similar relationships were observed when postoperative antibiotic information was ignored. Automated claims and pharmacy data from different health plans can be used together to allow inexpensive, routine monitoring of indicators of postoperative infection, with the goal of identifying institutions that can be further evaluated to determine if risks for infection can be reduced.
Platt et al. (Sun,) conducted a observational in Coronary Artery Bypass Graft (CABG) surgery (n=1,953). Automated health plan claims and pharmacy data surveillance was evaluated on Proportion of patients with an indicator of postoperative surgical site infection (p=<0.001). Automated claims and pharmacy data identified indicators of postoperative infection in 27% of CABG patients, revealing significant variation between hospitals (19% to 36%, p<0.001) that persisted after adjustment.
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