Public mortality rates identify extreme performers

Following reports that mortality rates may be a misleading quality indicator comes research that public reporting on percutaneous coronary intervention (PCI) fails to provide enough information to distinguish any difference in quality among most hospitals.

Publicly reported risk-adjusted mortality rates for nonemergent PCIs only accurately identified extremely high and low performers, concluded a study in the January issue of Circulation: Cardiovascular Quality and Outcomes.

The quality performance metrics of 351 cardiologists at 48 hospitals in New York between 1998 and 2007 also were not associated with a change in market share for hospitals or physicians, according to Lena M. Chen from the division of general medicine at the University of Michigan.

The study found that patients who selected a hospital whose prior reports were significantly better than expected in prior years had less chance of dying. Yet patients who chose a hospital in the top quartile of performance in prior years did not have lower risk-adjusted mortality rates.

Moreover, the researchers found no evidence that consumers, physicians or insurers used the public reports on mortality rates to guide market share, CMIO noted.

For more information:
- read the CMIO article
- here's the study abstract

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