Monitoring adverse outcomes of surgery using administrative data.

In this article, we document a stabilization in adverse outcomes associated with hysterectomies, cholecystectomies, and prostatectomies performed between 1972-73 and 1982-83 in Manitoba, Canada. The proportion of surgery performed by high-volume surgeons and by surgical specialists increased slightly over the decade. However, given the already low rates of adverse outcomes, these changes did not translate into significant decreases in the postoperative mortality rate or in the rate of related hospital readmissions. Reducing the proportion of adverse outcomes would be facilitated by identifying institutions with poorer than expected outcomes.