"Patients who are looking to have an elective surgery have almost no information to act upon to make a meaningful decision."
Marshall Allen
A new report is out that scores doctors based on their rates of complications for elective procedures. But some physicians and critics say the effort, while helpful, is limited by the data that it uses.
The report was put out by Pro Publica, an investigative news project. Their "surgeon scorecard" looked at claims data for nearly 17,000 surgeons. That data is based on Medicare billing for a handful of procedures. Marshall Allen was one of the reporters who wrote the story. He appeared recently on WNPR's Where We Live.
"Patients who are looking to have an elective surgery have almost no information to act upon to make a meaningful decision and an informed decision," Allen said.
So he and his team looked at eight elective surgeries -- hip replacements, knee replacements, three types of spinal fusions, laproscopic gall bladder removal, and two prostate surgeries. "
What we did was we identified every case where patients were readmitted within 30 days to the hospital after one of these low-risk elective surgeries," he said. "And we had a panel of doctors including surgeons who perform each of these procedures tell us which complications we should consider to be related to the surgery and, therefore, count as complications."
The point of the work is to inform patients and improve health outcomes. But while some physicians praise the impulse behind the report, they say it's limited by the data it uses. Dr. Peter Albertsen is a professor at UConn. He says the most important complications out there typically can't be measured by claims information.
"The real complications from my field, which is the prostate surgery field, are the long-term complications -- the risks of incontinence, impotence, and stricture," Albertsen said. "And, unfortunately, you can't measure those from claims data. Or they're extremely difficult from claims data. And it's the limitation of administrative claims data that is the difficult hurdle that many people who try to evaluate outcomes and evaluate healthcare keep bumping into."
Albertsen says the best way to learn about complications is to survey patients. In the meantime, people who want to learn more about their doctors based on claims data can do so at propublica.org.
