The predictive accuracy of the New York State coronary artery bypass surgery report-card system.
ABSTRACT We examined the impact of New York State's public reporting system for coronary artery bypass surgery fifteen years after its launch. We found that users who picked a top-performing hospital or surgeon from the latest available report had approximately half the chance of dying as did those who picked a hospital or surgeon from the bottom quartile. Nevertheless, performance was not associated with a subsequent change in market share. Surgeons with the highest mortality rates were much more likely than other surgeons to retire or leave practice after the release of each report card.
SourceAvailable from: Jeffrey S Mccullough
Annals of Surgery 07/2014; 260(1):3-4. DOI:10.1097/SLA.0000000000000677 · 7.19 Impact Factor
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ABSTRACT: Background Choice of hospital based on comparative performance information (CPI) was introduced for Dutch healthcare consumers at least 5 years ago, but CPI use has not yet become commonplace. Our aim was to assess the role of patients¿ expectations regarding variation in the quality of hospital care in determining whether they search for CPI.MethodsA questionnaire (for a cross-sectional survey) was distributed to 475 orthopaedic patients in a consecutive sample, who underwent primary hip or knee replacement in a university, teaching, or community hospital between September 2009 and July 2010.ResultsOf the 302 patients (63%) who responded, 13% reported searching for CPI to help them choose a hospital. People who expected quality differences between hospitals (67%) were more likely to search for CPI (OR =3.18 [95% CI: 1.02¿9.89]; p <0.04) than those who did not. Quality differences were most often expected in hospital reputation, distance, and accessibility. Patients who did not search for CPI stated that they felt no need for this type of information.Conclusion Patients¿ expectations regarding variation in quality of care are positively related to their reported search for CPI. To increase the relevance of CPI for patients, future studies should explore the underlying reasoning of patients about meaningful quality-of-care variation between hospitals.BMC Health Services Research 12/2014; 14(1):617. DOI:10.1186/s12913-014-0617-y · 1.66 Impact Factor