ProPublica, an independent, non-profit newsroom that produces investigative journalism in the public interest, created a searchable web app which allows anyone to search the Medicare database for specific hospitals or doctors and then to see their complication rates per Centers for Medicare and Medicaid Services (CMS).
Additionally, the app ranks both the hospitals and physicians against their peers.
This data is okay, not great.
To being with, this is Medicare data. It excludes patients under 65 years old which, for spine surgery, is the bulk of the market.
Also, there are many confounding reasons for any particular complication rate. This data does not account for co-morbidities like obesity, diabetes, prior surgeries, heart disease and other diagnosis which are associated in the literature with higher rates of complications. Some physicians will not perform revision surgeries, so their complication rates will be lower.
This data should be treated as more interesting and entertaining than useful for actually selecting a care provider.
We know from our sister company PearlDiver Technologies, Inc. that the data coming from CMS has a lot of noise in it.
Here is how ProPublica described their methodology:
“Our analysis is based on billing data hospitals submitted to Medicare from 2009-2013. We analyzed 2.3 million procedures: hip and knee replacements, three types of spinal fusion, gallbladder removals, prostate removals and prostate resections. ProPublica’s analysis accounted for factors such as patients’ health and age. We focused only on elective cases because they typically involve healthier patients with the best odds of a smooth recovery.”
Sources: Centers for Medicare and Medicaid Services; ProPublica Analysis
Authors and researchers: Marshall Allen, Olga Pierce, Mike Tigas, Al Shaw, Lena Groeger, Annie Waldman, Ryann Grochowski Jones, Jonathan Stray, Cecilia Reyes, Tobin Asher, Mariana Barbosa.
“If you spot an error, please let us know at scorecard@propublica.org.”
The ProPublica researchers found that the overall complication rates in the United States is low, ranging from 2% to 4%, depending on the type of surgery.
Furthermore, ProPublica found 756 surgeons in the database who performed at least 50 operations yet did not record a single complication in the five years covered by the analysis. Another 1, 423 surgeons had only one.
Bottom line, U.S. surgeons are excellent and overall have very low complication rates.
Of the ten largest metropolitan areas in the United States, here are the safest of the safest hospitals and surgeons. We listed the top five hospitals (as ranked by ProPublica from CMS data) in each metropolitan area plus the single surgeon at each hospital with the lowest complication rates.
| Metro Area | Hospitals With the Lowest Complication Rates and the Physician Associated With Each Hospital With the Lowest Complication Rate |
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1. Stanford Hospital, Stanford (Noman Khan) 2. Dominican Hospital, Santa Cruz (Christopher Summa) 3. Valleycare Medical Center, Pleasanton (Kevin Booth) 4. Washington Hospital, Fremont (Desmond Erasmus) 5. Good Samaritan Hospital, Fremont (Edward Rustamzadeh) |
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1. Baylor University Medical Center, Dallas (Robert Viere) 2. Methodist Hospital for Surgery, Addison (Andrew Park*) 3. Baylor Medical Center at Uptown, Dallas (Craig Callewart*) 4. Medical Center of Lewisville, Lewisville (Brady Giesler) 5. Texas Health Presbyterian Hospital Flower Mound, Flower Mound (Brady Giesler) |
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1. Grossmont Hospital, La Mesa (John Finkenberg) 2. Alvarado Hospital Medical Center (Choll Kim*) 3. Scripps Mercy Hospital, San Diego (Lance Alenau) 4. Sharp Memorial Hospital, San Diego (Richard Ostrup*) 5. Sharp Chula Vista Medical Center, Chula Vista (Lance Alenau) |
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1. South Texas Spine and Surgical Hospital, San Antonio (Gilbert Meadows) 2. Methodist Hospital, San Antonio (Tom Kingman) 3. Baptist Medical Center, San Antonio (Robert Johnson) 4. Innova Hospital San Antonio (Rafael Parra) 5. Christus Santa Rosa Hospital, (Gerardo Zavala*) |
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1. Scottsdale Healthcare Thompson Peak Hospital, Scottsdale (Justin Field) 2. Scottsdale Healthcare Shea Medical Center, Scottsdale (William Stevens*) 3. Surgical Specialty Hospital of Phoenix, Phoenix (Daniel Lieberman*) 4. Oasis Hospital, Phoenix (Dennis Crandall*) 5. Banner Thunderbird Medical Center, Glendale (Jonathan Landsman) |
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1. Pennsylvania Hospital of the University of Pa Health System, Philadelphia (Stephen Dante) 2. Jeanes Hospital, Philadelphia (Leonard Bruno) 3. Holy Redeemer Hospital and Medical Center, Meadowbrook (Gene Salkind*) 4. Phoenixville Hospital, Phoenixville (Sagi Kuznits) 5. Main Line Hospital Paoli, Paoli (Kenan Aksu*) |
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1. Houston Orthopedic and Spine Hospital, Bellaire (Stanley Jones) 2. Memorial Hermann Texas Medical Center, Houston (Vivek Kushwaha) 3. Methodist Sugar Land Hospital, Sugar Land (Jeffrey Wood) 4. Sugar Land Surgical Hospital LLP, Sugar Land (Mohammad Etminan) 5. Memorial Hermann Sugar Land Hospital, Sugar Land (Mohammad Etminan) |
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1. Skokie Hospital, Skokie (Noam Stadlan) 2. Evanston Hospital, Evanston (Michael Kornblatt*) 3. Northwest Community Hospital, Arlington Heights (E. Quinn Regan) 4. Palos Community Hospital, Palos Heights (Richard Lim) 5. Advocate Christ Hospital & Medical Center, Oak Lawn (Anis Mekhail*) |
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1. Cedars Sinai Medical Center, Los Angeles (Hyun Bae) 2. Saint John’s Health Center, Santa Monica (Khawar Siddique*) 3. Huntington Memorial Hospital, Pasadena (Ben Pradhan) 4. Methodist Hospital of Southern Ca, Arcadia (Christopher Aho*) 5. Verdugo Hills Hospital, Glendale (Ben Pradhan) |
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1. Hospital for Special Surgery, New York (Patrick O’Leary) 2. Englewood Hospital and Medical Center (Frank Moore) 3. Mount Sinai Hospital, New York (Mark Antonacci*) 4. Lenox Hill Hospital, New York (Mitchell Levine*) 5. Long Island Jewish Medical Center, New Hyde Park (Jeff Silber) |
*Occasionally, the same physician is listed at different hospitals but with the same CMS data. When that occurs, we selected the physician with the next lowest complication rate and designated this person with an asterisk.
Coming in future articles are the rankings for knee replacements, lumbar spine fusion anterior approach and cervical spine fusion.
The ProPublica app may be accessed at https://projects.propublica.org/surgeons/.
