MAY 12, 2006 -- Patients getting bypass surgery from surgeons or hospitals highly rated on quality performance measures were about half as likely to die as patients who received the surgery from a provider with poor ratings, according to a new study. Even so, there is no evidence indicating patients are using the performance data to select top-performing providers, the study's authors found.
The study published in the May/June edition of the journal Health Affairs looked at quality reporting on bypass surgery in New York and its effect on physicians and patients. It relied on publicly available data from 31 hospitals between 1989 and 2002.
"That patients can so dramatically cut their chances of dying by selecting a top performer says something powerful about how good the reporting system is," said study author Ashish Jha of the Harvard School of Public Health. "But there's no real evidence that patients use the information to pick a better hospital, even though it's free and easy to access."
The study also found that surgeons tied to poor performance were more likely to change their profession. Advocates might see that as a benefit of public reporting on quality, but study co-author Arnold Epstein sounded a note of caution. "If you have the right physicians labeled as poor performers, that's OK," Epstein said in a statement. "But if you have the wrong ones identified, then it is extraordinarily disruptive and can have very unfortunate consequences." The study concludes that the "large impact" on providers "underscores the need for highly accurate reporting" of data.
New York State began publicly reporting coronary artery bypass surgery deaths in 1991, and other states have used the New York program as a model, the authors noted.