Individual Surgeon’s Contribution to Value

Florence E. Turrentine, Min Woong Sohn, Margaret C. Tracci, Adriana G. Ramirez, Gilbert R. Upchurch, R. Scott Jones

Research output: Contribution to journalArticlepeer-review


Estimating surgeon-level value in health care remains relatively unexplored. American College of Surgeons National Surgical Quality Improvement Program Participant Use Files (2005-2013) were linked with total costs at a single institution. Random intercepts in 3-level random effects logistic regression models predicted 30-day postoperative mortality or morbidity for each surgeon each year. Value was defined as quality (morbidity or mortality) divided by costs for surgeons performing general surgery and vascular procedures. Forty-four surgeons performed 11 965 surgeries. Risk-adjusted costs trended down over time. For all surgeries, mortality value increased by 3.27 per year (95% confidence interval = 2.54-4.01; P <.001) on a 100-point scale, while morbidity value did not change. Of 21 surgeons with data for 5 years or longer, mortality value increased for all surgeons except one. Continuous increase in complication rates from 2008 contributed to decreased morbidity value. Value may assist surgeons in exploring performance opportunities better than morbidity or mortality alone.

Original languageEnglish
Pages (from-to)74-79
Number of pages6
JournalAmerican Journal of Medical Quality
Issue number1
StatePublished - Jan 1 2019

Bibliographical note

Publisher Copyright:
© The Author(s) 2018.


  • quality/cost
  • surgeon value
  • surgical outcomes
  • value

ASJC Scopus subject areas

  • Health Policy


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