Usefullness of 30-day mortality as measure of surgical quality in VHA patients

Editor's Note

In this study, researchers concluded that risk-adjusted postoperative 30-day mortality is useful as a surrogate for long-term outcomes in patients at Veterans Health Administration (VHA) hospitals.

Though the VHA has used 30-day mortality as a measure of surgical quality for more than 20 years, the measure has been criticized recently because of a theory that healthcare professionals manage patient care to meet the metric, and other outcome metrics are available.

Of nearly 11,000 mortality events analyzed, researchers found no evidence of compromise in patient care to meet the 30-day mortality metric. In all surgical specialties, survival at 30 days was associated with patient risks and correlated well with survival up to 1 year.

Importance For more than 2 decades, the Veterans Health Administration (VHA) has relied on risk-adjusted, postoperative, 30-day mortality data as a measure of surgical quality of care. Recently, the use of 30-day mortality data has been criticized based on a theory that health care professionals manage patient care to meet the metric and that other outcome metrics are available.