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Association Between Board Certification, Maintenance of Certification, and Surgical Complications in the United

Tim Xu1, Ambar Mehta1, Angela Park1

  • 1Johns Hopkins University, Baltimore, MD.

American Journal of Medical Quality : the Official Journal of the American College of Medical Quality
|January 19, 2019
PubMed

Insights

Physician board certification is linked to fewer surgical complications. However, Maintenance of Certification (MOC) completion alone did not show a similar association, suggesting a need for enhanced MOC assessments.

Area of Science:

  • Medical Quality Assurance
  • Surgical Outcomes Research
  • Physician Credentialing

Background:

  • Physician credentialing aims to enhance patient safety and quality.
  • Limited research exists on the direct impact of credentialing on surgical outcomes.

Purpose of the Study:

  • To investigate the association between physician board certification and Maintenance of Certification (MOC) completion with surgeon complication rates.
  • To analyze the relationship between credentialing processes and surgical quality for elective procedures.

Main Methods:

  • Analysis of national Medicare claims data from 2009-2013.
  • Inclusion of 1.9 million procedures performed by 14,598 surgeons across various specialties.
  • Comparison of complication rates between exemplar (lowest decile) and outlier (highest decile) surgeons based on board certification and MOC status.

Main Results:

  • Board-certified surgeons demonstrated a lower likelihood of being outlier surgeons (OR 0.79 [0.66-0.94]).
  • Maintenance of Certification (MOC) completion was not significantly associated with reduced complication rates in orthopedic surgery or urology.
  • The study identified a potential link between board certification and improved surgical performance.

Conclusions:

  • Physician board certification may be a marker for reduced surgical complications.
  • Current Maintenance of Certification (MOC) requirements may need enhancement with methods like skills assessment and peer review.
  • Further research into improved MOC components could advance surgical quality and patient safety.
Keywords:
board certificationhealth policymaintenance of certificationsurgical quality

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