Evidence map›Paper›PMID 37821560›Full record

ArticleSurgical endoscopy2024

Use of statewide financial incentives to improve documentation of hernia and mesh characteristics in ventral hernia repair.

Sean M O'Neill, Brian T Fry, Wenjing Weng, Michael Rubyan, Ryan A Howard, Anne P Ehlers, Michael J Englesbe, Justin B Dimick, Dana A Telem

Abstract read
In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sean M O'NeillDepartment of Surgery, Michigan Medicine, University of Michigan, Taubman Center, TC 2924B, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA. oneillsm@med.umich.edu.ORCID 0000-0001-7759-8942
Brian T FryDepartment of Surgery, Michigan Medicine, University of Michigan, Taubman Center, TC 2924B, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
Wenjing WengMichigan Surgical Quality Collaborative, Ann Arbor, MI, USA.
Michael RubyanCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
Ryan A HowardDepartment of Surgery, Michigan Medicine, University of Michigan, Taubman Center, TC 2924B, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
Anne P EhlersDepartment of Surgery, Michigan Medicine, University of Michigan, Taubman Center, TC 2924B, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
Michael J EnglesbeDepartment of Surgery, Michigan Medicine, University of Michigan, Taubman Center, TC 2924B, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
Justin B DimickDepartment of Surgery, Michigan Medicine, University of Michigan, Taubman Center, TC 2924B, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
Dana A TelemDepartment of Surgery, Michigan Medicine, University of Michigan, Taubman Center, TC 2924B, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.

Funding

Sex as a Biologic Variable in Groin HerniaK08DK135919 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Anne Pugel Ehlers · 2024 to 2026
$478k
NIDDK NIH HHS K08 DK135919NIDDK NIH HHS L30 DK134076
6 · The paper itself

Abstract

backgroundDocumentation of intraoperative details is critical for understanding and advancing hernia care, but is inconsistent in practice. Therefore, to improve data capture on a statewide level, we implemented a financial incentive targeting documentation of hernia defect size and mesh use.

methodsThe Abdominal Hernia Care Pathway (AHCP), a voluntary pay for performance (P4P) initiative, was introduced in 2021 within the statewide Michigan Surgical Quality Collaborative (MSQC). This consisted of an organizational-level financial incentive for achieving 80% performance on eight specific process measures for ventral hernia surgery, including complete documentation of hernia defect size and location, as well as mesh characteristics and fixation technique. Comparisons were made between AHCP and non-AHCP sites in 2021.

resultsOf 69 eligible sites, 47 participated in the AHCP in 2021. There were N = 5362 operations (4169 at AHCP sites; 1193 at non-AHCP sites). At AHCP sites, 69.8% of operations had complete hernia documentation, compared to 50.5% at non-AHCP sites (p < 0.0001). At AHCP sites, 91.4% of operations had complete mesh documentation, compared to 86.5% at non-AHCP sites (p < 0.0001). The site-level hernia documentation goal of 80% was reached by 14 of 47 sites (range 14-100%). The mesh documentation goal was reached by 41 of 47 sites (range 4-100%).

conclusionsAddition of an organizational-level financial incentive produced marked gains in documentation of intra-operative details across a statewide surgical collaborative. The relatively large effect size-19.3% for hernia-is remarkable among P4P initiatives. This result may have been facilitated by surgeons' direct role in documenting hernia size and mesh use. These improvements in data capture will foster understanding of current hernia practices on a large scale and may serve as a model for improvement in collaboratives nationally.

Indexed as

Hernia, VentralHerniorrhaphyHumansReimbursement, IncentiveSurgical MeshHernia size documentationMesh use documentationPay-for-performanceSurgical care collaborative

Identifiers

PMID37821560
PMCPMC11482032

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.