Public Reporting of Percutaneous Coronary Intervention Mortality in New York State
Are We Helping Our Patients?
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
In this issue of Circulation: Cardiovascular Quality and Outcomes, Fernandez et al1 report the results of their survey of interventional cardiologists (ICs) and patients in New York State (NYS), with a goal of examining clinicians’ and patients’ perceptions toward publically reported physician-specific outcomes in NYS for percutaneous coronary intervention (PCI) procedures. First, they examined whether the changes made in 2006 and 2010 to exclude patients presenting with refractory cardiogenic shock or anoxic brain injury have impacted physician attitudes. The ICs were asked 9 simple questions on their NYS report cards and its changes over the past 10 years; these responses were then compared with same group’s 2003 questionnaire. The majority of physicians disagreed or strongly disagreed that the NYS PCI report provided an accurate measure of physician quality (90%), provided useful information for the public (78%), or served to improve patient care (75%). Two thirds of ICs agreed that the decision to exclude patients with anoxic brain injury or refractory cardiogenic shock from public reporting made them more likely to perform PCI in these subgroups of patients. Interestingly, the responses to 4 identical statements used in both 2003 and 2016 surveys did not show any significant interval differences in physician responses. The second goal of this study, and perhaps more impactful, was to evaluate patients’ knowledge and attitudes on public reporting of physician-specific outcomes data. Not surprisingly, patient awareness of the NYS Department of Health public reporting of PCI was very low; the overwhelming majority (95%) of patients had never heard of the NYS PCI reports. Despite poor awareness, the majority of patients felt that knowing physician’s procedural mortality data would provide an accurate measure of the quality of the physician. The differences between patient and physician perceptions of NYS PCI reports were remarkably contradictory: 60% of patients …