ProPublica Launches Surgeon Scorecard Website, Grading On Complication Rates

The independent, non-profit investigative journalism group ProPublica has developed a new surgeon scorecard which evaluates the complication rates associated with specific doctors throughout the U.S. 

The new scorecard was launched on July 14, allowing users to find surgeons and hospitals near them, then calculates the rate of complications and deaths based off of eight elective procedures. The results indicate whether the physician has high, medium or low adjusted surgical complication rates.

The data was compiled using Medicare billing records for in-patient hospital stays from 2009 through 2013. The surgeries used to score the surgeons involved different types of spinal fusion procedures, knee and hip replacements, gall bladder removal and prostate removals and prostate resections.

According to an explanation article published by ProPublica to explain how the scorecard was created, the group chose those surgeries because they are generally performed on relatively low-risk, healthy patients.

The data was reviewed by a panel of at least five doctors, who looked at factors such as age, patient health, overall hospital performance, and diagnosis codes on cases where patients were readmitted within 30 days. The panel determined whether the readmission, given the data available, was likely due to a surgical complication. When a majority of the doctors disagreed, Pro Publica threw that case out.

Researchers found that some of the more common complications included blood clots, infections, bleeding events, or misaligned orthopedic devices.

The scorecard contains data on 16,827 surgeons in 3,575 hospitals, and only rates surgeons if they have performed an operation more than 20 times.

A number of recent studies have focused on complication rate patterns in recent months, in efforts to determine what factors are most likely to lead to surgical complications that could harm patients.

Last month, a study published in The Lancet found that patients readmitted to the hospital where their surgery was first conducted are less likely to die than those who go to a different hospital.

Researchers speculate the reason for the decreased risk of death may be surgeons who perform the initial surgeries take the time to thoroughly perform the big operation. They get to know the area being operated on, how the surgery went and if there were complications. Doctors who did not perform the original surgery will not have the information from the first surgery to be able to put the readmission or complication into context.

Another study published in May in the U.S. News & World Report on Hospital Quality revealed patients undergoing surgical procedures at smaller hospitals may face a higher risk of severe complications and death compared to patients operated on at busier hospitals. Researchers say this may be due to a lack of sufficient practice for surgical teams.

Some patients will travel outside of their local area to have a more complex operation performed at a larger more prestigious hospital. However, when complications arise later, they will be admitted to a hospital closer to where they live under the care of a doctor who is unfamiliar with their condition or surgery.