Assessing Resident Cataract Surgery Outcomes Using Medicare Physician Quality Reporting System Measures

被引：16

作者：

Finn, Avni P. ^{[1
]}

Borboli-Gerogiannis, Sheila ^{[1
,2
]}

Brauner, Stacey ^{[1
,2
]}

Chang, Han-Ying Peggy ^{[1
,2
]}

Chen, Sherleen ^{[1
,2
]}

Gardiner, Matthew ^{[1
,2
]}

Greenstein, Scott H. ^{[1
,2
]}

Kloek, Carolyn ^{[1
,2
]}

Miller, Joan W. ^{[1
,3
]}

Chen, Teresa C. ^{[1
,4
]}

机构：

[1] Harvard Med Sch, Dept Ophthalmol, Boston, MA USA

[2] Massachusetts Eye & Ear Infirm, Comprehens Ophthalmol & Cataract Consultat Serv, Boston, MA 02114 USA

[3] Massachusetts Eye & Ear Infirm, Retina Serv, Boston, MA 02114 USA

[4] Massachusetts Eye & Ear Infirm, Glaucoma Serv, 243 Charles St, Boston, MA 02114 USA

来源：

JOURNAL OF SURGICAL EDUCATION | 2016年 / 73卷 / 05期

关键词：

surgical training; cataract; PQRS measures; benchmarks of surgical care; resident evaluation;

D O I：

10.1016/j.jsurg.2016.04.007

中图分类号：

G40 [教育学];

学科分类号：

040101 ; 120403 ;

摘要：

OBJECTIVES: To assess resident cataract surgery outcomes at an academic teaching institution using 2 Physician Quality Reporting System (PQRS) cataract measures, which are intended to serve as a proxy for quality of surgical care. DESIGN: A retrospective review comparing cataract surgery outcomes of resident and attending surgeries using 2 PQRS measures: (1) 20/40 or better best-corrected visual acuity following cataract surgery and (2) complications within 30 days following cataract surgery requiring additional surgical procedures. SETTING: An academic ophthalmology center. PARTICIPANTS: A total of 2487 surgeries performed at the Massachusetts Eye and Ear Infirmary from January 1, 2011 to December 31, 2012 were included in this study. RESULTS: Of all 2487 cataract surgeries, 98.95% achieved a vision of at least 20/40 at or before 90 days, and only 0.64% required a return to the operating room for postoperative complications. Of resident surgeries, 98.9% (1370 of 1385) achieved 20/40 vision at or before 90 days follow-up. Of attending surgeries, 99.0% (1091 of 1102) achieved 20/40 vision at or before 90 days (p = 1.00). There were no statistically significant differences between resident and attending cases regarding postoperative complications needing a return to the operating room (i.e., 0.65%, or 9 of 1385 resident cases vs 0.64%, or 7 of 1102 attending cases; p = 1.00). CONCLUSIONS: Using PQRS Medicare cataract surgery criteria, this study establishes new benchmarks for cataract surgery outcomes at a teaching institution and supplemental measure for assessing resident surgical performance. Excellent cataract outcomes were achieved at an academic teaching institution, with results exceeding Medicare thresholds of 50%. There appears to be no significant difference in supervised trainee and attending cataract surgeon outcomes using 2 PQRS measures currently used by Medicare to determine physician reimbursement and quality of care. (C) 2016 Published by Elsevier Inc. on behalf of the Association of Program Directors in Surgery

引用

页码：774 / 779

页数：6

共 9 条

[1]

[Anonymous], 2013 QUAL OUTC

[2]

[Anonymous], PQRS MEAS SPEC SPEC

[3]

Centers for Medicare & Medicaid Services, PHYS QUAL REP SYST P

[4] Objective assessment of skills in intraocular surgery (OASIS) [J].