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Abstract:
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Provider profiles, or report cards, are routinely developed to assess the quality of care for various conditions and procedures, as in the Centers for Medicare and Medicaid Services’ Hospital Compare and ProPublica’s Surgeon Scorecard. Profiling providers of surgical cancer care poses challenges related to a high number of low-volume providers, particularly if analyses are to be undertaken separately for specific cancer sites. Often, different thresholds are used to define low-volume providers that are then excluded from analyses and/or public reporting. We performed a head-to-head comparison of fixed and random effects methods of profiling providers of surgical cancer care with particular emphasis on low volume providers. We compared the width of the confidence interval for the estimate of the hospital effect, detection of outliers, and correlation of performance measures between methods.
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