Quality assessment and improvement in interventional cardiology: A position statement of the society of cardiovascular angiography and interventions, Part II: Public reporting and risk adjustment

Klein, Lloyd W.; Ho, Kalon K.L.; Singh, Mandeep; Anderson, H. Vernon; Hillegass, William B.; Uretsky, Barry F.; Chambers, Charles; Rao, Sunil V.; Reilly, John P.; Weiner, Bonnie H.; Kern, Morton J.; Bailey, Steven R.

doi:10.1002/ccd.23153

Cited by 25 publications

(14 citation statements)

References 70 publications

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“…20,21 These studies have led to a concern that public reporting of PCI outcomes could result in providers refusing high-risk patients. 18e20, 22,23 Our study found small differences in the number of patients treated with PCI for cardiogenic shock, after cardiac arrest, or as salvage treatment for STEMI consistent with these concerns. However, using a validated risk adjustment model developed specifically for the CathPCI Registry, states with public reporting and states without public reporting had similar predicted mortality rates, suggesting that public reporting is not associated with meaningful differences in the patients treated with PCI.…”

Section: Discussionsupporting

confidence: 78%

State Mandated Public Reporting and Outcomes of Percutaneous Coronary Intervention in the United States

Cavender

Joynt

Parzynski

et al. 2015

The American Journal of Cardiology

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Public reporting has been proposed as a strategy to improve health care quality. Percutaneous coronary interventions (PCIs) performed in the United States from July 1, 2009, to June 30, 2011, included in the CathPCI Registry were identified (n = 1,340,213). Patient characteristics and predicted and observed in-hospital mortality were compared between patients treated with PCI in states with mandated public reporting (Massachusetts, New York, Pennsylvania) and states without mandated public reporting. Most PCIs occurred in states without mandatory public reporting (88%, n = 1,184,544). Relative to patients treated in nonpublic reporting states, those who underwent PCI in public reporting states had similar predicted in-hospital mortality (1.39% vs 1.37%, p = 0.17) but lower observed in-hospital mortality (1.19% vs 1.41%, adjusted odds ratio [ORadj] 0.80; 95% confidence interval [CI] 0.74, 0.88; p <0.001). In patients for whom outcomes were available at 180 days, the differences in mortality persisted (4.6% vs 5.4%, ORadj 0.85, 95% CI 0.79 to 0.92, p <0.001), whereas there was no difference in myocardial infarction (ORadj 0.97, 95% CI 0.89 to 1.07) or revascularization (ORadj 1.05, 95% CI 0.92 to 1.20). Hospital readmissions were increased at 180 days in patients who underwent PCI in public reporting states (ORadj 1.08, 95% CI 1.03 to 1.12, p = 0.001). In conclusion, patients who underwent PCI in states with mandated public reporting of outcomes had similar predicted risks but significantly lower observed risks of death during hospitalization and in the 6 months after PCI. These findings support considering public reporting as a potential strategy for improving outcomes of patients who underwent PCI although further studies are warranted to delineate the reasons for these differences.

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Section: Discussionsupporting

confidence: 78%

State Mandated Public Reporting and Outcomes of Percutaneous Coronary Intervention in the United States

Cavender

Joynt

Parzynski

et al. 2015

The American Journal of Cardiology

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“…The importance of unbiased local or external peer review cannot be overemphasized. 67,68 Implementation of the SCAI Quality Toolkit and certification by Accreditation for Cardiovascular Excellence [ACE] are recommended as resources for improving quality. • Advanced malignancy.…”

Section: Pci-gl Ecdmentioning

confidence: 99%

SCAI/ACC/AHA Expert Consensus Document: 2014 Update on Percutaneous Coronary Intervention Without On-Site Surgical Backup

et al. 2014

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“…Federal legislation, such as the Health Care Quality Improvement Act of 1986, and individual state legislation serve, in part, to provide physicians with legal protections while they are participating in the peer review process. 23,24 …”

Section: Brigham and Women's Hospital Cqi Process And Case Presentationmentioning

confidence: 99%

Quality Measurement and Improvement in the Cardiac Catheterization Laboratory

2012

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Quality assessment and improvement in interventional cardiology: A position statement of the society of cardiovascular angiography and interventions, Part II: Public reporting and risk adjustment

Cited by 25 publications

References 70 publications

State Mandated Public Reporting and Outcomes of Percutaneous Coronary Intervention in the United States

State Mandated Public Reporting and Outcomes of Percutaneous Coronary Intervention in the United States

SCAI/ACC/AHA Expert Consensus Document: 2014 Update on Percutaneous Coronary Intervention Without On-Site Surgical Backup

Quality Measurement and Improvement in the Cardiac Catheterization Laboratory

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