Value of surgical care
Ten large teaching hospitals, in collaboration with the Dutch College of Surgeons (NvVH – Nederlandse Vereniging van Heelkunde), DICA, and X-IS, have build a powerful tool to get insight in the value of care of five patientgroups: colorectal cancer, aneurysm, carotid, cholecystectomy and hernia inguinalis. Outcomes and costs were linked on a patient level. Outcomes were extracted from the clinical registrations from DICA and in addition we defined textbook outcome (the ‘perfect outcome’ for a patient) for cholecystectomy and hernia inguinalis, costs were standardized for all hospitals and supplied from the hospital information system.
Every quarter we organized a central meeting in which the participating hospitals shared their own results with the other hospitals in a transparent and open manner. The discussion on how to improve quality with ten different hospitals (surgeons, managers, board, datamanagers, policymakers etc) and how much this will cost. This sparked interesting discussions about differences and similarities, and as a result, hospitals learned from each other.
Next steps are to include PROMs in the analysis, to extent the analysis over the full cycle of care and the movement to bundled payments for these patient groups.