Advance Access: National Databases for Neurosurgical Outcomes Research: Options, Strengths, and Limitations

Value-based care delivery,1 alternative payment models,2 quality improvement, publicly reported surgeon scorecards,3 and individualized patient care depend on accurate, complete, and large clinical and financial databases. The development of databases that contain robust outcome, process, and structural measures presents an invaluable opportunity for surgeons to influence future policy changes while improving the quality of individual patient care.4

Neurosurgical interventions are among the most expensive and scrutinized services offered by inpatient hospitals and ambulatory centers. Neurosurgeons have been leaders in responding to the value agenda with a dramatic increase in the number of large, multicenter, national database studies.47 The use of these data streams and creation of additional ones, such as those that include patient-reported outcomes measures, are an integral part of the provider-led effort to demonstrate high-value care by improving outcomes and eliminating unnecessary costs.

Though neurosurgeons are rapidly adapting to the use of national databases for outcomes research, the neurosurgical literature lacks a comprehensive review of large national databases. In this study, we assessed the strengths and limitations of various resources for outcomes research in neurosurgery.

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