Abstract 16534: State Mandated Public Reporting of Percutaneous Coronary Intervention Outcomes is Associated with Better Outcomes: A report from the NCDR®
Introduction: The effectiveness of public reporting as a strategy to improve quality of care and outcomes is controversial. The data supporting an association between public reporting and outcomes among patients undergoing percutaneous coronary intervention (PCI) is conflicting.
Methods: All unique patients undergoing PCI from July 1, 2009-June 30, 2011 with demographic/hospital data included in the CathPCI Registry® were identified (n=1,349,319). Patient demographics, predicted mortality (from the NCDR PCI Risk Model) and observed mortality were compared between patients treated with PCI in states mandating public reporting (MA, NY, PA, NJ) versus all other states without mandated public reporting. GEE logistic regression models, accounting for patient clustering within centers, were used to determine differences in in-hospital mortality between the two groups after adjusting for potential confounding factors.
Results: Patients undergoing PCI in public reporting states (12%, n=164,775) were older and more likely to be undergoing elective PCI, but fewer patients had diabetes or prior coronary revascularization. Relative to patients treated in non-public reporting states, those undergoing PCI in public reporting states had similar model-predicted in-hospital mortality (1.37% vs. 1.39%, p= 0.86) but lower observed mortality (1.20% vs. 1.41%, p=<0.001). After risk adjustment, those undergoing PCI in states that mandated public reporting had lower adjusted odds of mortality (OR 0.81; 95% CI 0.75, 0.89; p-value 0.002).
Conclusion: Undergoing PCI in states with mandated public reporting is associated with lower mortality. Further studies are warranted to evaluate the reasons for these differences and to assess the suitability of public reporting as a possible strategy for improving outcomes of patients undergoing PCI.
- © 2012 by American Heart Association, Inc.