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Sep 2011, Vol 146, No. 9 >

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Invited Critique | Sep 2011

Preventing Unintended Consequences of Quality Measurement:  Comment on “Surgical Site Infections and Cost in Obese Patients Undergoing Colorectal Surgery”

Elise H. Lawson, MD, MSHS; Clifford Y. Ko, MD, MS, MSHS
Arch Surg. 2011;146(9):1072-1073. doi:10.1001/archsurg.2011.225.
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Wick and colleagues1 report an important study in which they used a large administrative database to examine the association between obesity and surgical site infection (SSI) in patients undergoing colectomy. The authors interpret their results within the context of an increasing call for public reporting of infection rates and incorporation of SSI into pay-for-performance policies, cautioning that such programs may incentivize surgeons to preferentially operate on nonobese patients. The authors' message is clear, timely, and appropriate. We would like to further highlight 2 pertinent issues: preventing unintended consequences and the source of data for quality evaluation.

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