Public Reporting of PCI Outcomes

May 21, 2019
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Authors:
Wadhera RK, O’Brien CW, Joynt Maddox KE, et al.
Citation:
Public Reporting of Percutaneous Coronary Intervention Outcomes: Institutional Costs and Physician Burden. J Am Coll Cardiol 2019;73:2604-2608.
Summary By:
Bina Ahmed, MD, FACC

Study Questions:

What are the time and financial impacts of public reporting of percutaneous coronary intervention (PCI)-related outcomes on institutions in Massachusetts?

Methods:

The authors surveyed all cardiac catheterization laboratories in Massachusetts and asked about institutional costs, staff requirements, time spent by interventional cardiologists, and perception regarding overall administrative work associated with public reporting.

Results:

Response rate was low (15/24 cath labs responded to the survey). The median range of annual institutional costs was $100,000-$200,000. Median number of full-time staff needed to facilitate data input for public reporting was 1.0 (range 0.5-2.75). Median time spent by interventional cardiologists was 5-10 hours/week. The perceived burden for meeting public reporting expectations was 7/10 (10 being high burden). The majority of respondents perceived the burden of public reporting to outweigh the beneficial impacts on outcomes (64%).

Conclusions:

The mandate to meet public reporting requirements in Massachusetts results in considerable financial burden to participating sites and most participants did not perceive the benefits to outweigh the time and cost-related burden of public reporting mandates.

Perspective:

Public reporting of PCI-related outcomes have not consistently shown improvement in the quality of care. Furthermore, states with public reporting tend to drive physicians to be inappropriately risk averse in fear of impact of poor outcomes on publicly available ratings. The results of the current survey shed light on yet another unintended consequence of public reporting; the financial and time burden on institutions, administrative staff, and physicians. Although quality improvement should always be a goal, public reporting may not be the best way to achieve this goal. It may be time to re-assess the need and value of public reporting of PCI-related outcomes and to look at alternatives that improve quality and outcomes more effectively.

Keywords: Cardiac Catheterization, Cardiology Interventions, CathPCI Registry, Costs and Cost Analysis, Mandatory Reporting, Outcome Assessment, Health Care, Percutaneous Coronary Intervention, Quality Improvement, Risk


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