A 1-year prospective analysis was undertaken of all non-day-case general surgery in a district general hospital.
Using the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) scoring system 3004 patients were assessed.
From the predictions of mortality and morbidity so obtained, a quality measure, the ratio of observed to expected numbers of deaths and complications (O : E ratio) was determined for each surgeon, both overall and within specialty zones.
The present study demonstrates the serious hazard in using « raw » uncorrected mortality and morbidity statistics to compare surgeon performance.
Mortality rates varied from 1.0 to 4.9 per cent whereas O : E ratios ranged from 0.83 to 1.06 ; morbidity rates varied from 5.3 to 12.6 per cent with O : E ratios 0.86-1.02.
Great misunderstanding may result from the publication of surgeon or hospital « league tables ».
The present study demonstrates a technique that might allow surgeon performance to be monitored adequately and accurately.
Mots-clés Pascal : Exploration, Homme, Chirurgien, Performance, Analyse risque, Ajustement, Mortalité, Morbidité, Angleterre, Grande Bretagne, Royaume Uni, Europe
Mots-clés Pascal anglais : Exploration, Human, Surgeon, Performance, Risk analysis, Fitting, Mortality, Morbidity, England, Great Britain, United Kingdom, Europe
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0255899
Code Inist : 002B30A01A1. Création : 01/03/1996.