RISK ADJUSTMENT FOR EVALUATING THE OUTCOME OF UROLOGICAL OPERATIVE PROCEDURES

Purpose: Considerable public and media attention has been directed in recent years toward comparing performance at individual hospitals. So-called death league tables have been published in the media, ranking hospitals according to crude mortality rates. Crude rates of mortality and morbidity are clearly misleading. Therefore, scoring systems comparing treatment outcomes among physicians or hospitals on an objective basis are urgently required.Materials and Methods: During a 12-month period we prospectively evaluated 651 patients at 2 urological units using a simple and well validated surgical scoring system. Patients had been admitted to the units for routine urological operations. The scoring system consists of a simple preoperative physiological score, a postoperative severity score and defined types of complications.Results: The morbidity and mortality rates for unit 1 were 7.4% and 1.3%, respectively. For unit 2 the morbidity and mortality rates were 14% and 8.8%, respectively. Despite the marked dif...