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(Circulation. 2007;116:2897-2899.)
© 2007 American Heart Association, Inc.

Editorial

Cardiac Report Cards

How Can They Be Made Better?

Jack V. Tu, MD, PhD, FRCPC; Peter C. Austin, PhD

From the Institute for Clinical Evaluative Sciences (J.V.T., P.C.A.), Toronto, Ontario, Canada; Division of Cardiology (J.V.T.), Shulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; and University of Toronto (J.V.T., P.C.A.), Toronto, Ontario, Canada.

Correspondence to Dr Jack V. Tu, Institute for Clinical Evaluative Sciences, G106-2075 Bayview Ave, Toronto, Ontario, M4N 3M5 Canada. E-mail tu@ices.on.ca

Key Words: Editorials • cardiovascular diseases • cardiopulmonary bypass • myocardial infarction

An extract of the first 250 words of the full text is provided, because this article has no abstract.

When hospital- and surgeon-specific coronary artery bypass graft surgery death rates were first publicly released in 1991 in New York State, many clinicians reacted with anger and outright hostility.¹ Over time, as more jurisdictions adopted the concept of public reporting of outcomes in the form of report cards, the view has shifted to gradual recognition and acceptance that cardiac report cards, however imperfect, are here to stay.

Articles pp 2960 and 2969

Professional associations such as the American College of Cardiology and American Heart Association have recognized the importance of measuring the processes and outcomes of cardiovascular care as a critical step in improving the quality of care delivered to patients.² The field of cardiovascular medicine has been at the forefront of the "accountability" movement in health care for a number of reasons. Cardiovascular disease affects large sectors of the population, because conditions such as acute myocardial infarction and procedures such as bypass surgery are quite common, and tracking of hard objective outcomes such as death are readily available. Furthermore, much clinical research has focused on cardiovascular disease and generated a large base of scientific evidence on which care can be assessed and improved. Most recently, policy makers have embraced the concept of "pay for performance," which is based on the premise that economic rewards may stimulate better quality of care delivery.³

The debate about report cards has progressed from fundamental disagreements about their purpose and usefulness to discussions that focus on their content and the statistical methodology to be . . . [Full Text of this Article]

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