Comparative audit: an experimental study of 147,882 general surgical admissions during 1990.
In 1991, 1025 general surgical Fellows of The Royal College of Surgeons of England were circulated with a pro forma and asked to submit local audit results for admissions during 1990 to a confidential comparative audit service. The individual topics of cholecystectomy and colorectal resection were studied. Data returned by 160 surgeons concerned 147,882 admissions including 122,620 operations. Overall mortality rates ranged from 0 to 5 per cent and morbidity rates from 0 to 22 per cent. Laparoscopic cholecystectomy was associated with one-quarter of the mortality rate and two-thirds the morbidity rate of open cholecystectomy. Of the 33 surgeons who responded to a survey after the presentation of results, all wished to continue the exercise in future years; 39 per cent had been stimulated to perform further analyses and 15 per cent had changed practice habits as a result. Comparative audit involving large numbers of patients and surgeons is feasible and seems beneficial to participants.
Dunn
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DC
Confidential Comparative Audit Service, Royal College of Surgeons of England, London, UK.
Fowler
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S
D002763:Cholecystectomy / Q000706:statistics & numerical data; D003106:Colon / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008485:Medical Audit; D009017:Morbidity; D012007:Rectum / Q000601:surgery; D013514:Surgical Procedures, Operative / Q000401:mortality*