Revisiting Turkish Esophageal Atresia Regisrty data for quality indicators

Aim: The Turkish Esophageal Atresia Registry (TEAR) data were revisited using quality indicators (QIs) to evaluate quality care provided to patients with esophageal atresia (EA). Methods: Among 36 centers registering data in the TEAR database, only those treating more than four patients per year were included. Based on predefined QIs, each center was assessed for structural, procedural and outcome indicators. Mean percentages were calculated for each QI. Centers with a lower-than-mean percentage for adverse outcomes were determined as ‘meeting’ that QI, while those with higher percentage were defined as ‘not meeting’ it. Results: Fifteen centers and 525 patients were analyzed. MDTs existed in 80 % centers while 33 % had transition-to-adulthood programs. One center met the 91 % of all QIs, whereas, 2 centers met 82 % of them and 3 of them met 73 %. Two centers met only 36 % of all indicators. The most frequently met QIs were the presence of MDTs and low intraoperative complications (n = 12, 80 %) whereas anastomotic strictures were the least met (n = 6, 40 %). No correlation was found between the number of patients treated per centers and the number of QIs met (p > 0.05). The presence transition-to-adulthood facilities was associated with a significantly reduced rate of intraoperative complications compared with centers lacking such resources (p = 0.008). Conclusions: QIs allow centers to gain insight into their EA care and compare their performance with that of other centers. Although the centers in TEAR met most of the QIs, certain measures—such as the rate of anastomotic stricture—should be improved at the national level.