The Association between Participation in a Quality Collaborative and Value in Lung Cancer Surgery.

Background: In this study, the association between participation in a statewide thoracic surgery quality collaborative initiative(CQI) and value for resection of lung cancer is evaluated.

Methods: Data from the Michigan Value Collaborative, a quality initiative with the goal of improving healthcare value and quality across Michigan by leveraging robust multi-payer claims data to identify patients undergoing lung cancer resection at Michigan hospitals from 2015-2020. We identified patients who did and did not receive their care at a hospital participating in a statewide thoracic surgery CQI. There were 16 CQI hospitals and 38 non- CQI hospitals identified where patients underwent resection for lung cancer. Multi-variable logistic and linear regression were performed to compare surgical outcomes and total surgical episodes for patients receiving care within the CQI compared to those outside of the CQI

Results: Overall, a total of 4,857 patients undergoing resection for lung cancer were identified with patient mean (SD) age of 68.3 (8.6) with 2,599 women (53.5%). Patients receiving surgery within CQI hospitals had significantly lower mortality compared to patients at non-CQI hospitals (1.5% vs. 2.6%; P<0.04). A similar pattern was found for all complications(48.4% vs. 60.6%, %; P<0.001) and specific complications including acute respiratory failure (11.1% vs. 25.4%: P<0.001), pneumonia(6.4% vs. 10.1%; P<0.001), pneumothorax (20.3% vs. 25.3%; P<0.001), and renal failure(6.0% vs. 9.2%:P<0.001). Lastly, CQI hospitals had significantly lower mean 30-day total surgical episode payments ($26,470.42 vs. $28,561.56; P<0.001).

Conclusions: This study finds association between participation in a collaborative quality initiative and improved value in lung cancer surgery.