‘Commitment to Quality’ Common Among NCDR Hospitals Participating in Public Reporting Program

About one-third of eligible hospitals participated in ACC’s voluntary public reporting program, with characteristics suggesting “a commitment to quality” may be more common among facilities enrolled in the program, according to a study published Feb. 10 in JAMA Network Open.

Yulanka S. Castro-Dominguez, MD, FACC, et al., looked at hospital characteristics and participation in the voluntary public reporting program among sites enrolled in ACC’s CathPCI Registry and EP Device Implant Registry, previously the ICD Registry. The study included all hospitals that participated in either of the two registries from July 2014, when the public reporting program launched, through May 2017. The researchers also looked at enrollment trends following the 2016 announcement that U.S. News & World Report would assign credit to hospitals that participated in public reporting in its annual “Best Hospitals” guidebook. 

During the first year of the public reporting program, enrollment increased by 86.5% from 37 hospitals to 69 hospitals. In March 2016, one month after the U.S. News & World Report announcement, the number of hospitals enrolled in public reporting increased from 240 to 376. As of May 2017, 1,747 hospitals were eligible for public reporting, of which 561 (32.1%) were enrolled, including 531 sites participating in the CathPCI Registry and 374 participating in the EP Device Implant Registry.

Hospitals that participated in public reporting were more likely to be located in an urban region or in the Midwest or Northeast, be owned by a university, be part of a health system, and have higher bed capacity. Participating hospitals also had higher median volume of PCI and ICD procedures and were more likely to participate in five or more NCDR registries (142 hospitals vs. 93 hospitals). In addition, participating hospitals were more likely to be in states with mandatory public reporting programs (73 hospitals vs. 100 hospitals) and to have participated in the voluntary PCI 30-day readmission public reporting pilot program (204 hospitals vs. 136 hospitals). 

Among hospitals participating in public reporting, an increased proportion adhered to composite discharge medications after PCI (0.96 vs. 0.92; p<0.001) and ICD (0.88 vs. 0.81; p<0.001). Hospitals participating in public reporting had a higher proportion of four-star ratings, compared with hospitals that did not participate, for both the CathPCI Registry (77% vs. 44.2%; p<0.001) and the EP Device Implant Registry (30.0% vs. 10.8%; p<0.001).

According to the researchers, the findings “suggest that hospitals with an already-established structure, culture, and experience around quality improvement and public reporting may be more likely to participate in other similar initiatives.” They add that one-third of eligible hospitals participated in ACC’s public reporting program, with greater participation among hospitals with “characteristics and experience surrounding quality measurement and public reporting.” Additional research “may be warranted to increase adoption of public reporting and to assess characteristics of other public reporting initiatives,” they conclude.

Clinical Topics: Invasive Cardiovascular Angiography and Intervention

Keywords: Accreditation, Registries, Pilot Projects, Patient Readmission, Patient Discharge, Percutaneous Coronary Intervention, Quality Improvement, National Cardiovascular Data Registries, EP Device Implant Registry, CathPCI Registry

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