Is It Time to Measure Complications from the NTBD? A Longitudinal Analysis of Recent Reporting Trends

Background Payers have approached select complications as never-events yet there is rationale that achieving a zero incidence of these events is impractical. Prior 2005 NTDB analysis showed high rates (37%) of centers reporting no complications data making national estimates for determining standardized complication rates difficult to ascertain. Methods The 2008-2012 NTDB-NSP nationally weighted files were utilized to calculate yearly national estimates. Rates were compared in all centers and those reporting complications data. Hospital characteristics were compared using student’s t-test. In 2011, an ‘other complication’ category was introduced; overall rates were calculated with and without this category. Yearly estimates were reported for patients receiving care within centers reporting complications data. Results From 2008-2012 NTDB, there was raw data on 3,657,884 patients. 16.3% (n=594,894) experienced 1 or more complications (82.7% one complication;17.3% two or more complications). Excluding the ‘other complication’ category, the overall weighted rate was 8.4%-9.2%. Pneumonia was the most common complication (2.7-3.0%), occurring at twice the 2005 rate. The number of centers reporting no complications data dropped to 8.1% in 2011 (2008:14.5%, 2009:18.2%, 2010:15.9%, 2012:8.9%). By 2012, nearly all level I centers reported complications whereas 46.4% of level IVs reported none (I 0.5%, II 2.7%, III 8.5%, p=0.04). Data were reported the least frequently in non-teaching hospitals (15.8%, p=0.007), those in the South (19.6%, p=0.007), and those with

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