Decrease in observed and expected mortality rates, risk factor rates from 2002 to 2014 in Massachusetts
MONDAY, April 30, 2018 (HealthDay News) — Mandatory reporting of cardiac surgery outcomes for coronary artery bypass grafting (CABG) in Massachusetts from 2002 to 2014 was associated with improved outcomes, according to a study presented at the annual meeting of the American Association for Thoracic Surgery, held from April 28 to May 1 in San Diego.
David M. Shahian, M.D., from Massachusetts General Hospital in Boston, and colleagues obtained annual CABG data for 45,264 procedures from 14 programs, including risk factors, observed and expected mortality (OM and EM) rates, market share, and data coding changes after peer adjudication. Data were compared with national registry data provided by the Society of Thoracic Surgeons (STS).
The researchers observed a decrease in Massachusetts OM and EM from 2002 to 2014 (27.4 percent decrease in OM, from 2.19 to 1.59 percent). Annual OM and EM in Massachusetts were consistently lower than national rates from the STS. Three outliers were identified in surgeon-level reporting from 2005 to 2010; after discontinuation of surgeon reporting, Massachusetts OM and EM increased and stabilized slightly below STS rates (2014: OM, 1.59 versus 2.07 percent). Over the study period there was a decrease in the rates of critical risk factors, which were consistently lower than corresponding STS rates.
“The bottom line is that mandatory public reporting was consistently associated with better outcomes, although a causal relationship cannot be proven, and there was conflicting and inconclusive evidence for risk aversion,” Shahian said in a statement.
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