Association Between Participation in a Quality Collaborative and Value in Lung Cancer Surgery

In this study, the association between participation in a statewide thoracic surgery collaborative quality initiative (CQI) and value for resection of lung cancer is evaluated.

Robust multipayer claims data from the Michigan Value Collaborative, a quality initiative with the goal of improving health care value and quality across Michigan, were leveraged to identify patients undergoing lung cancer resection at Michigan hospitals from 2015 to 2020. We identified patients who did and did not receive their care at a hospital participating in a statewide thoracic surgery CQI. There were 16 CQI hospitals and 38 non-CQI hospitals identified at which patients underwent resection for lung cancer. Multivariable logistic and linear regression analyses were performed to compare surgical outcomes and total surgical episodes for patients receiving care within the CQI compared with those outside of the CQI.

A total of 4857 patients undergoing resection for lung cancer were identified, with mean (SD) age of 68.3 (8.6) years; 2599 (53.5%) were women. Patients receiving surgery within CQI hospitals had significantly lower mortality compared with patients at non-CQI hospitals (1.5% vs 2.6%; P < .04). A similar pattern was found for all complications (48.4% vs 60.6%; P < .001) and for specific complications, including acute respiratory failure (11.1% vs 25.5%; P < .001), pneumonia (6.4% vs 10.1%; P < .001), pneumothorax (20.3% vs 25.3%; P < .001), and renal failure (5.9% vs 9.3%; P < .001). Last, CQI hospitals had significantly lower mean 30-day total surgical episode payments ($26,470.42 vs $28,561.56; P < .001).

This study found association between participation in a CQI and improved value in lung cancer surgery.