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Impact of Public Reporting of Coronary Artery Bypass Graft Surgery Performance Data on Market Share, Mortality, and Patient Selection

Bibliographic Data

ID9101673
AuthorsPatrick S Romano (0000-0001-6749-3979, Pediatrics and Genetics, corresponding author), James P Marcin (0000-0001-7281-6947, Pediatrics and Genetics, corresponding author), Jian J Dai, Jian Dai (0000-0002-8906-3360, UC Davis Health System), Xiaowei Yang (0000-0002-8421-7420, UC Davis Health System), Xiaowei D Yang, Richard L Kravitz (0000-0001-5575-529X, Center For Policy Research, corresponding author), David M Rocke (0000-0002-3958-7318, UC Davis Health System), Madan Dharmar (0000-0001-5256-2652, Pediatrics and Genetics), Zhongmin Li (0000-0003-0530-3484)
Year2011
Volume49
Issue12
Pages1118-1125
Publication date2011-12-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3182358c78
PMID22002641
OpenAlexW1982198855
LanguageEN
Citations received2
References cited29

BACKGROUND: The impact of publicly reporting risk-adjusted outcomes for hospitals and surgeons remains controversial, with particular concern about unintended consequences. OBJECTIVES: We evaluated the impact of 3 reports from the voluntary California CABG Mortality Reporting Program (CCMRP) on hospital market share, hospital mortality, and patient selection for coronary artery bypass graft (CABG) surgery. RESEARCH DESIGN AND PARTICIPANTS: We analyzed data from January 2000 to December 2005 for all patients receiving isolated CABG surgery in California. We compared hospital groups based on their quality classification, including low-mortality outliers ("better"), high-mortality outliers ("worse"), and nonoutliers, as well as participation in the CCMRP. MEASURES: We compared changes in market share, risk-adjusted mortality, and hospital caseload of high-risk patients for isolated CABG surgeries before and after the public release of 3 CCMRP reports (July 2001, August 2003, and February 2005). RESULTS: Low-mortality outlier hospitals experienced significantly increased market share for isolated CABG surgery in the first 6 months after the public release of the CCMRP reports (relative change in adjusted mean market share=8.9%, P=0.002). We found no evidence to suggest reduced risk adjusted mortality after the release of the CCMRP reports, but high-mortality outlier hospitals, on average, operated on less sick patients (relative change in mean expected mortality=25%, P=0.02). CONCLUSIONS: The release of public CABG hospital performance reports in California was associated with increased volume at low-mortality hospitals, and may have reduced referrals of high-risk patients to high-mortality hospitals (or risk avoidance)

Cardiology · Selection (genetic algorithm) · Computer Science · Emergency Medicine · Healthcare Policy and Management · Internal Medicine · Medicine · Patient Satisfaction in Healthcare · Primary Care and Health Outcomes

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Unique citing works2
Citations per year0,25
Citation span2018 - 2018 (1)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 2
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