1. Detecting Hospital Outliers in Post-Pancreatectomy Care Using Funnel Plots from 2009–2018 Based on Nationwide Medico-Administrative Data
- Author
-
Anne-Sophie Mariet, Olivier Facy, Serge Aho, Alexandre Doussot, Catherine Quantin, Alain Bernard, Jonathan Cottenet, Service de chirurgie cardio-vasculaire et thoracique (CHU Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service Biostatistiques et Informatique Médicale (CHU de Dijon) (DIM), Service de bactériologie et hygiène hospitalière [Nantes], Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Chirurgie Digestive, Cancérologique, Générale, Endocrinienne et Urgences (CHU de Dijon), Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques (CIC-EC), Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Institut National de la Santé et de la Recherche Médicale, Inserm, The authors would like to thank Suzanne Rankin (Dijon University Hospital) for revising the manuscript. This work was supported by the Multi-organization Cancer Institute (Institut th?matique multi-organismes cancer: ITMO Cancer), the Public Health Research Institute (Institut de Recherche en Sant? Publique: IRESP) and the French National Institute of Health and Medical Research (Institut national de la sant? et de la recherche m?dicale: INSERM) in the context of the 2014?2019 cancer plan., The authors would like to thank Suzanne Rankin (Dijon University Hospital) for revising the manuscript. This work was supported by the Multi-organization Cancer Institute (Institut thématique multi-organismes cancer: ITMO Cancer), the Public Health Research Institute (Institut de Recherche en Santé Publique: IRESP) and the French National Institute of Health and Medical Research (Institut national de la santé et de la recherche médicale: INSERM) in the context of the 2014–2019 cancer plan., and HAL UVSQ, Équipe
- Subjects
medicine.medical_specialty ,Funnel plot ,Original Scientific Report ,Databases, Factual ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,Hospital quality ,Pancreatic surgery ,03 medical and health sciences ,Pancreatectomy ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,business.industry ,General surgery ,Mortality rate ,Hospitals ,3. Good health ,[SDV] Life Sciences [q-bio] ,Cardiothoracic surgery ,Mortality data ,030220 oncology & carcinogenesis ,Surgery ,National database ,France ,business - Abstract
Objectives Our objective was to identify hospitals with unusual mortality rates for major pancreatectomies over a period of ten years using 30-day mortality data from the French national database. Methods Data for all patients who underwent pancreatectomy were extracted from the national medico-economic database (Programme de Médicalisation des Systèmes d'Information). To identify quality outliers for each hospital, the observed-to-expected 30-day mortality rates were used as a quality indicator. Results A total of 19 494 patients underwent a major pancreatectomy in France between January 2009 and December 2018. The overall 30-day mortality rate was 4.8% (n = 944). For the 2009–2014 period, the funnel plot showed that 10 of the 176 hospitals lie outside the central 95% region and 7 lie outside the central 99.8% region. For the 2015–2018 period, out of 176 hospitals, 6 lie outside the central 95% region and 2 lie outside the central 99.8% region. The change in standardized mortality ratios between 2009–2014 and 2015–2018 testing for differences from the overall change, they were there 4 hospitals lie outside the central 95% region and 0 lie outside the central 99.8% region. Conclusion Over time, the improvement in hospital quality was weak. This study suggests that there is a pressing need to reorganize the supply of care for pancreatic surgery in France.
- Published
- 2021