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Focus on Quality Can Improve Care, Reduce Disparities and Reduce Costs in Hospitals



Hospitals Participating in the American College of Surgeons' NSQIP Program Prevent 
250-500 Complications Annually, per Hospital; Health Reform Measures Focused on Quality Can Improve Care, Reduce Disparities and Reduce Costs

CHICAGO  –  Hospitals participating in the American College of Surgeons' National Surgical Quality Improvement Program (ACS NSQIP) have shown significant improvement in patient mortality and morbidity and are preventing 262-524 complications per hospital, per year, according to a new study in the September issue of the Annals of Surgery,  currently available online.

“Reducing complications equates to better patient outcomes and studies show better quality care reduces lengths of stay and can lower costs,” said Clifford Y. Ko, MD, MS, MSHS, FACS, director of the Division of Research and Optimal Patient Care, American College of Surgeons, and a co-author of the study. “If these results were translated across all U.S. hospitals, we would have the potential to prevent millions of complications a year, save potentially billions of dollars a year and provide evidence to health care reformers that higher quality care can cost less,” said Dr. Ko.

ACS NSQIP is the first risk-adjusted, clinical, outcomes-based program to measure and improve the quality of surgical care across various specialties in the private sector. The study evaluated the 118 hospitals that began participating in ACS NSQIP between 2005-2007. Of those hospitals, 82 percent have seen improvement in morbidity and 66 percent have seen improvement in mortality rates. Hospitals achieved an 11 to 17 percent improvement in these measures annually.

According to the study, hospitals that were poorer performers at the time they joined the ACS NSQIP program achieved greater improvements in quality of care and were more likely to improve morbidity rates. All hospitals – large and small, urban and rural – were able to improve their quality of care.

Previous studies have shown the significant cost of surgical complications, ranging from nearly $13,000 in additional costs to treat a urinary tract infection and $8,500 to treat venous thromboembolism (VTE), to more than $28,000 in additional costs to treat a surgical site infection. This study indicates hospitals are improving patient care while reducing disparities in care and saving millions of dollars.

"The study shows ACS NSQIP hospitals do improve the quality of patient care and that improvement continues over time," said Dr. Ko. "Using outcomes-based, risk-adjusted measures, both underperforming and high-performing hospitals of all sizes in both urban and rural settings can improve care and reduce the disparities of care among hospitals."

The ACS NSQIP program provides a prospective, peer-controlled, validated database of pre-operative to 30-day surgical outcomes based on clinical data, not claims data. It was originally launched in the 1990s by the Veterans Health Administration. In 2001, the American College of Surgeons first piloted the program in private sector hospitals in partnership with the Agency for Healthcare Research and Quality (AHRQ), and the program was made available to all private sector hospitals in 2005. Nearly 250 hospitals participate in the program today.

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About the American College of Surgeons
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 74,000 members and is the largest organization of surgeons in the world. For more information, visit

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Online August 20, 2009

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