The complementary value of trained abstractors and surgeons in the more accurate assessment of surgical quality.

The authors acquired valid clinical data representative of patients who choose to undergo elective operations. Their results indicate that complementary data recorded by paid, trained abstractors and from the specialist surgeon and his/her office staff on hospital events add major evaluative components to those derived from administrative data sets. The cost of these extra reports is reasonable, and they provide a more complete review of the entire episode of care, extending to the return to normal activities. If "quality" is to be validly reported and used for assessment, punishment, or reward processes, then the value of these 2 sources is too great to ignore.