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Surgical care improvement project in the value-based purchasing era: more harm than good?
Clin Infect Dis. 2013 Feb; 56(3):424-7.CI

Abstract

The Surgical Care Improvement Project (SCIP) started in 2006 as a core measure to reduce perioperative morbidity and mortality, with many measures addressing perioperative antibiotic usage and timing. However, measures are often rolled out without consideration of their full impact, causing confusion, frustration, and possibly patient harm. We have provided examples of each. The institution of SCIP has markedly increased the compliance to its measures but little evidence shows that it provides any substantial benefit to patients, whereas this improved compliance comes at the cost of significant time, money, and staff resources. Despite this, several SCIP measures, which are currently incorporated into quality contracts, will be tied to Medicare reimbursement in 2013 under value-based purchasing, with third-party payers likely following suit. This may lead to inappropriate lower compensation of hospitals providing good care with questionable effects on patient outcomes.

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Authors+Show Affiliations

Weston A
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA. aweston@tuftsmedicalcenter.org
Caldera K
No affiliation info available
Doron S
No affiliation info available

MeSH

HumansMedicarePerioperative CarePostoperative ComplicationsQuality Assurance, Health CareReimbursement MechanismsSurgical Wound InfectionUnited StatesValue-Based Purchasing

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

23143099

Citation

Weston, Adam, et al. "Surgical Care Improvement Project in the Value-based Purchasing Era: More Harm Than Good?" Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 56, no. 3, 2013, pp. 424-7.
Weston A, Caldera K, Doron S. Surgical care improvement project in the value-based purchasing era: more harm than good? Clin Infect Dis. 2013;56(3):424-7.
Weston, A., Caldera, K., & Doron, S. (2013). Surgical care improvement project in the value-based purchasing era: more harm than good? Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 56(3), 424-7. https://doi.org/10.1093/cid/cis940
Weston A, Caldera K, Doron S. Surgical Care Improvement Project in the Value-based Purchasing Era: More Harm Than Good. Clin Infect Dis. 2013;56(3):424-7. PubMed PMID: 23143099.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical care improvement project in the value-based purchasing era: more harm than good? AU - Weston,Adam, AU - Caldera,Kathleen, AU - Doron,Shira, Y1 - 2012/11/09/ PY - 2012/11/13/entrez PY - 2012/11/13/pubmed PY - 2013/6/21/medline SP - 424 EP - 7 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 56 IS - 3 N2 - The Surgical Care Improvement Project (SCIP) started in 2006 as a core measure to reduce perioperative morbidity and mortality, with many measures addressing perioperative antibiotic usage and timing. However, measures are often rolled out without consideration of their full impact, causing confusion, frustration, and possibly patient harm. We have provided examples of each. The institution of SCIP has markedly increased the compliance to its measures but little evidence shows that it provides any substantial benefit to patients, whereas this improved compliance comes at the cost of significant time, money, and staff resources. Despite this, several SCIP measures, which are currently incorporated into quality contracts, will be tied to Medicare reimbursement in 2013 under value-based purchasing, with third-party payers likely following suit. This may lead to inappropriate lower compensation of hospitals providing good care with questionable effects on patient outcomes. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/23143099/Surgical_care_improvement_project_in_the_value_based_purchasing_era:_more_harm_than_good L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/cis940 DB - PRIME DP - Unbound Medicine ER -