Association of Hospital Participation in a Quality Reporting Program With Surgical Outcomes and Expenditures for Medicare Beneficiaries

Abstract
Increased scrutiny of hospital performance has led to a proliferation of clinical registries used to benchmark outcomes. One of the most visible national quality reporting programs is the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP).1-3 The cornerstone of this program is an extensive clinical registry, with data abstracted directly from the medical record by trained personnel.1,4,5 The program provides hospitals with reports that include a detailed description of their risk-adjusted outcomes (eg, mortality, specific complications, and length of stay). These reports allow hospitals to benchmark their performance relative to all other ACS NSQIP hospitals. Participating hospitals are encouraged to focus improvement efforts on areas in which they perform poorly.