For patients with ovarian cancer, focusing solely on hospital readmission rates as a quality measure might worsen long-term outcomes while unfairly penalizing the best hospitals, suggest the results of two analyses of the National Cancer Database presented at the annual meeting of the Society of Gynecologic Oncology.
Hospitals with the highest ovarian cancer caseloads had the best rates of overall survival and post-surgical mortality, but also had the highest rates of readmission within 30 days after post-surgical discharge, reported IHPI member, Shitanshu Uppal, MBBS, of the obstetrics and gynecology department at U-M.
Studies of ovarian cancer have shown post-surgical readmission rates of 10%-20%, Dr. Uppal said. To evaluate readmissions as a quality metric in this setting, he and his associates identified patients diagnosed with stage III or stage IV high-grade serous carcinoma between 2004 and 2013 who underwent cytoreductive surgery as primary treatment. More than 44,000 patients meeting these criteria were treated at hospitals that handled anywhere from under 10 to more than 30 cases annually.