Solving the Value Equation: Assessing Surgeon Performance Using Risk-Adjusted Quality-Cost Diagrams and Surgical Outcomes

William S. Knechtle, Sebastian D. Perez, Mehul V Raval, Patrick S. Sullivan, Yazan M. Duwayri, Felix Fernandez, Joe Sharma, John F. Sweeney*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Quality-cost diagrams have been used previously to assess interventions and their cost-effectiveness. This study explores the use of risk-adjusted quality-cost diagrams to compare the value provided by surgeons by presenting cost and outcomes simultaneously. Colectomy cases from a single institution captured in the National Surgical Quality Improvement Program database were linked to hospital cost-accounting data to determine costs per encounter. Risk adjustment models were developed and observed average cost and complication rates per surgeon were compared to expected cost and complication rates using the diagrams. Surgeons were surveyed to determine if the diagrams could provide information that would result in practice adjustment. Of 55 surgeons surveyed on the utility of the diagrams, 92% of respondents believed the diagrams were useful. The diagrams seemed intuitive to interpret, and making risk-adjusted comparisons accounted for patient differences in the evaluation.

Original languageEnglish (US)
Pages (from-to)532-540
Number of pages9
JournalAmerican Journal of Medical Quality
Volume32
Issue number5
DOIs
StatePublished - Sep 1 2017

Keywords

  • cost-effectiveness planes
  • evaluation
  • provider
  • quality-cost diagrams

ASJC Scopus subject areas

  • Health Policy

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