The National Neurosurgery Quality and Outcomes Database Qualified Clinical Data Registry: 2015 measure specifications and rationale

Abstract

<jats:p>Meaningful quality measurement and public reporting have the potential to facilitate targeted outcome improvement, practice-based learning, shared decision making, and effective resource utilization. Recent developments in national quality reporting programs, such as the Centers for Medicare &amp; Medicaid Services Qualified Clinical Data Registry (QCDR) reporting option, have enhanced the ability of specialty groups to develop relevant quality measures of the care they deliver. QCDRs will complete the collection and submission of Physician Quality Reporting System (PQRS) quality measures data on behalf of individual eligible professionals. The National Neurosurgery Quality and Outcomes Database (N<jats:sup>2</jats:sup>QOD) offers 21 non-PQRS measures, initially focused on spine procedures, which are the first specialty-specific measures for neurosurgery. Securing QCDR status for N<jats:sup>2</jats:sup>QOD is a tremendously important accomplishment for our specialty. This program will ensure that data collected through our registries and used for PQRS is meaningful for neurosurgeons, related spine care practitioners, their patients, and other stakeholders. The 2015 N<jats:sup>2</jats:sup>QOD QCDR is further evidence of neurosurgery’s commitment to substantively advancing the health care quality paradigm. The following manuscript outlines the measures now approved for use in the 2015 N<jats:sup>2</jats:sup>QOD QCDR. Measure specifications (measure type and descriptions, related measures, if any, as well as relevant National Quality Strategy domain[s]) along with rationale are provided for each measure.</jats:p>

Predictors of extended length of stay, discharge to inpatient rehab, and hospital readmission following elective lumbar spine surgery: introduction of the Carolina-Semmes Grading Scale

“…In an attempt to curb increasing expenditures, the Centers for Medicare and Medicaid Service, private insurers, and other health care purchasers have initiated several cost containment and quality improvement measures. 5,9,37 Perhaps the most common among these novel payment and quality improvement programs is capitated bundled care contracting for spine surgery and other health care services. These contracts require hospitals and their physicians to "bundle" facility and professional charges for necessary care throughout a defined longitudinal episode of care, and to assume all risk of cost/utilization overruns.…”

Methods for Developing the American College of Rheumatology's Electronic Clinical Quality Measures

“…Although eCQMs require a significant upfront investment in development, testing, and deployment, they have potential to decrease measurement burden over time for practicing clinicians (5). Moreover, generating reports at both local and national levels through the use of aggregated patient registries has started to facilitate rapid cycle quality improvement efforts in some specialties (23,24).…”

Assessment of cost drivers and cost variation for lumbar interbody fusion procedures using the Value Driven Outcomes database

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