Abstract 11541: Does Public Reporting Improve State Average Risk-Adjusted Outcomes Among Medicare Beneficiaries Undergoing Coronary Revascularization Procedures During Fiscal Year 2011
Background: Three states; New York (NY), Massachusetts (MA), and Pennsylvania (PA) have a history of publicly reporting coronary revascularization procedure (CRP) outcomes. This study reports difference in hospital risk-adjusted mortality, lives saved, and procedure rates among hospitals in states with public reporting versus those hospitals in seven northeasterly states that do not publicly report outcomes for CRPs.
Methods: This retrospective study examined the (MedPar) File to identify all MB undergoing either coronary bypass graft (CABG) surgery without any valve surgery or any percutaneous coronary intervention (PCI) during fiscal year 2011. The study population consists of 85,389 MBs in 712 hospitals that preformed at least 52 CABG surgeries and 308,680 MBs in 1,315 hospitals that that performed at least 52 PCIs. ICD-9 procedure codes were used to identify procedures and co-morbidities. Separate logistic regression equations (controlling for 25 demographic characteristics and co-morbidities) were estimated to predict each MB’s probability of experiencing in-hospital death. Hospital risk-adjusted mortality rates, total lives saved, and procedure rates and ranks were calculated. Hospital outcomes for the 10 northeastern states of interest were divided into two groups: states with public reporting; NY, MA, and PA, and states without public reporting; Maine, Vermont, New Hampshire, Connecticut, Rhode Island, Maryland, and Delaware.
Results: The table reports average hospital level procedure volume and outcomes for predicted risk-adjusted mortality rate, total lives saved, and the ranking (out of 712 CABG hospitals and 1,315 PCI hospitals) by study group.
Conclusions: Overall, hospitals in states with publically reported CRP outcomes perform more procedures per 1,000 MBs, have lower risk-adjusted mortality rates and save more lives than hospitals in study states that do not publically report CRP outcomes.
- © 2013 by American Heart Association, Inc.