Lumbar Spine Fusion (Posterior): Safest Hospitals, Safest Doctors, Ranked

ProPublica, an independent, non-profit newsroom that produces investigative journalism in the public interest, created a searchable web app which allows anyone to search the Medicare database for specific hospitals or doctors and then to see their complication rates per Centers for Medicare and Medicaid Services (CMS).

Additionally, the app ranks both the hospitals and physicians against their peers.

This data is okay, not great.

To being with, this is Medicare data. It excludes patients under 65 years old which, for spine surgery, is the bulk of the market.

Also, there are many confounding reasons for any particular complication rate. This data does not account for co-morbidities like obesity, diabetes, prior surgeries, heart disease and other diagnosis which are associated in the literature with higher rates of complications. Some physicians will not perform revision surgeries, so their complication rates will be lower.

This data should be treated as more interesting and entertaining than useful for actually selecting a care provider.

We know from our sister company PearlDiver Technologies, Inc. that the data coming from CMS has a lot of noise in it.

Here is how ProPublica described their methodology:

“Our analysis is based on billing data hospitals submitted to Medicare from 2009-2013. We analyzed 2.3 million procedures: hip and knee replacements, three types of spinal fusion, gallbladder removals, prostate removals and prostate resections. ProPublica’s analysis accounted for factors such as patients’ health and age. We focused only on elective cases because they typically involve healthier patients with the best odds of a smooth recovery.”

Sources: Centers for Medicare and Medicaid Services; ProPublica Analysis

Authors and researchers: Marshall Allen, Olga Pierce, Mike Tigas, Al Shaw, Lena Groeger, Annie Waldman, Ryann Grochowski Jones, Jonathan Stray, Cecilia Reyes, Tobin Asher, Mariana Barbosa.

“If you spot an error, please let us know at scorecard@propublica.org.”

The ProPublica researchers found that the overall complication rates in the United States is low, ranging from 2% to 4%, depending on the type of surgery.

Furthermore, ProPublica found 756 surgeons in the database who performed at least 50 operations yet did not record a single complication in the five years covered by the analysis. Another 1, 423 surgeons had only one.

Bottom line, U.S. surgeons are excellent and overall have very low complication rates.

Of the ten largest metropolitan areas in the United States, here are the safest of the safest hospitals and surgeons. We listed the top five hospitals (as ranked by ProPublica from CMS data) in each metropolitan area plus the single surgeon at each hospital with the lowest complication rates.

San Jose, California

9

Dallas, Texas

8

San Diego, California

7

San Antonio, Texas

6

Phoenix, Arizona

5

Philadelphia, Pennsylvania

4

Houston, Texas

3

Chicago, Illinois

2

Los Angeles, California

1

New York City, New York

*Occasionally, the same physician is listed at different hospitals but with the same CMS data. When that occurs, we selected the physician with the next lowest complication rate and designated this person with an asterisk.

Coming in future articles are the rankings for knee replacements, lumbar spine fusion anterior approach and cervical spine fusion.

The ProPublica app may be accessed at https://projects.propublica.org/surgeons/.