Public Reporting II
State of the Art—Current Public Reporting in Cardiovascular Medicine
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- outcome and process assessment (health care)
- outcome assessment (health care)
- quality indicators, health care
- quality of health care
Public reporting of clinical outcomes is now common. Despite the considerable problems summarized in an earlier article,1 governmental and commercial entities offer public reporting of hospital and physician performance over the Internet. We subsequently review common sources of public information on cardiovascular care in the United States.
Perhaps the best known governmental reporting website is Hospital Compare (https://www.medicare.gov/hospitalcompare/search.html) operated by the Centers for Medicare and Medicaid Services (CMS). All hospitals that provide care for CMS patients are expected to participate. The website includes (1) structural measures, such as participation in national clinical databases; (2) evaluation of patient experiences, using the Hospital Consumer Assessment of Healthcare Providers and Systems Survey; (3) timeliness and effectiveness of care; (4) complications; (5) 30-day readmission rates for certain diagnoses, (6) 30-day mortality rates for certain diagnostic groups; (7) efficient use of outpatient imaging; and (8) payments, including payments for care after hospital discharge for some conditions, such as congestive heart failure or myocardial infarction. The majority of the data are abstracted from CMS databases, but some data come from other government sources (eg, infection data may come from the Centers for Disease Control and Prevention) or commercial agencies (eg, Hospital Consumer Assessment of Healthcare Providers and Systems Survey data originate with Press Ganey or other authorized vendors). Hospitals are ranked on 64 measures (including an overall measure) and are assigned 1 to 5 stars, 5 being best. The method used to calculate the star ratings is complex but described well in CMS websites (https://www.qualitynet.org/). Hospital Compare is intuitive and easy to use, but there is little instruction about how to use these data meaningfully.
The Hospital Compare model was adapted for reporting on individual physician performance in Physician Compare (https://www.medicare.gov/physiciancompare/). This registry uses an existing governmental Healthcare Provider Directory to sort data …