No association between hospital-reported perioperative venous thromboembolism prophylaxis and outcome rates in publicly reported data.

NoAssociation BetweenHospital-Reported Perioperative Venous Thromboembolism Prophylaxis andOutcomeRates in Publicly ReportedData Venous thromboembolism (VTE), consisting of deep vein thrombosis (DVT) and pulmonary embolism, is an important cause of postoperative mortality and long-term morbidity. Because many events are preventable, VTE prophylaxis performance and postoperative VTE are used as measures of hospital quality of care and patient safety. Two such metrics are reported on the Centers for Medicare & Medicaid Services Hospital Compare website (http://www .medicare.gov/hospitalcompare/search.html) with the stated goal of helping consumers make decisions about where to receive their health care. TheSurgicalCare ImprovementProject (SCIP)VTE-2,aprocessmeasure, captures the percentage of a hospital’s surgical patients who received any VTE prophylaxis within 24 hours of surgery. Previous studies have shown that performance on the SCIP VTE-2 measure is not associated with VTE among Medicarepatients in6high-risk surgical procedures,1 norwith outcomes in a Veterans Affairs cohort.2 In October 2011, Hospital Compare made additional VTE outcomes data available toconsumers.Wehypothesized that there isnoassociationbetween the process measure (SCIP VTE-2) and the outcome (Agency forHealthcareResearchandQualityPatient Safety Indicator [PSI]–12, a risk-adjusted postoperative VTE rate based on administrative data).