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Using Patient Outcomes to Evaluate General Surgery Residency Program Performance.

Neha Bansal¹, Kristina D Simmons², Andrew J Epstein³

¹Perelman School of Medicine at the University of Pennsylvania, Philadelphia2Department of Surgery, Center for Surgery and Health Economics, University of Pennsylvania Health System, Philadelphia.

|October 29, 2015

Summary

This summary is machine-generated.

General surgery residency programs can be ranked by patient outcomes, but differences between top and bottom programs were small. Performance metrics showed slight variations, suggesting caution for payment-for-performance initiatives.

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Area of Science:

Medical Education
Surgical Outcomes
Health Services Research

Background:

Evaluating general surgery residency programs requires measurable performance indicators.
Linking program performance to objective patient outcomes is crucial for financial rewards.

Purpose of the Study:

To assess general surgery residency program performance using patient clinical outcomes.
To establish a ranking system for residency programs based on graduate performance.

Main Methods:

Retrospective cohort study of 230,769 patients from 349 hospitals (2008-2011).
Analysis included 73 general surgery residency programs and 454 surgeons.
Outcomes measured: in-hospital death, postoperative complications, prolonged length of stay, and failure to rescue.

Main Results:

Surgeons from top-ranked residency programs had significantly lower adverse event rates.
Adjusted adverse event rates showed small but significant differences between top and bottom tertile programs.
The impact of residency program ranking on outcomes diminished with increased years of surgical practice.

Conclusions:

Objective data can successfully rank general surgery residency programs by graduate clinical outcomes.
Rankings varied depending on the specific outcome measure used.
The magnitude of outcome differences between programs was small, necessitating careful consideration for payment-for-performance initiatives in graduate medical education.