NSQIP, meanwhile, "may be more relevant to quality. For instance, the definition of skin and soft tissue infection, while a very common diagnosis/complication, varies widely in the claims data but has a strict definition by NSQIP," Dr. Rubin said. "While NSQIP is expensive (both the enrollment and FTE required), it depends on the quality of the data as to whether it is too resource-intensive. I’m sure hospitals have spent a lot more on SCIP [Surgical Care Improvement Project (pdf)] than on NSQIP for a lot less improvement in quality."
NSQIP remains the gold standard, Dr. Rubin said. "The use of good clinical data carefully collected and carefully risk-adjusted is, in my opinion, the way to go," he said. "I’m worried that lesser claims data will not be accurate but will be acted upon as if it were."
Dr. Sessler said he agrees that the NSQIP registry is a valuable resource, but notes that it applies to a limited number of hospitals, and fewer than 1% of U.S. surgical patients. "Specially trained nurses must abstract clinical details from the records of each NSQIP patient," he said. "Because NSQIP applies to so few patients in so few hospitals, it cannot be used to compare hospital performance." In contrast, he said, the Risk Stratification Index can be used for all patients and all hospitals.