Can we rate heart surgeries like blenders?
The Consumers Union, publisher of Consumer Reports, released a set of ratings yesterday for something rather more important than appliances: heart bypass surgery. Using data submitted to the Society of Thoracic Surgeons (STS), the Consumers Union has graded various heart surgery groups using a three-star scale, similar to the way it rates radios, cameras and washing machines. It's a set of valuable public data that could serve as a model for expanding the Department of Health and Human Services' open government sites like Data.medicare.gov and the Community Health Data Initiative.
The heart surgery ratings are based on factors like survival rates, complications and the use of particular surgical techniques such as the toronto cpr training practices. The information, which has been collected in a registry by the STS since 1989, comes from patients' charts and is available for 90 percent of cardiac surgery programs in the US, although only about 20 percent of those programs have elected to make their data public through Consumer Reports.
The New England Journal of Medicine called the report "a watershed event in health care accountability," and although the information has been voluntarily reported, and therefore isn't complete, the Journal notes that the participating physicians have praised the methods of this study. The data has been risk-adjusted, meaning it takes into account complicating factors like the severity of a patient's disease and any other health conditions they may have. Without proper risk adjustment, physicians fear they could be penalized for taking on more dire cases.
Such specific and well-documented clinical outcomes are difficult to come by. The Centers for Medicare and Medicaid Services (CMS) collects quality data voluntarily from physicians for its Physician Quality Reporting Initiative. The PQRI rewards providers with bonuses for reporting certain quality measures, such as the percentage of their asthmatic patients who receive one of CMS' preferred inhaler types. But the results of these surveys aren't available to the public. And for good reason, CMS representatives say — the statistics aren't risk-adjusted and are only reported by some doctors. As the New England Journal of Medicine article noted, it took a "long, complex and expensive" process to bring this data into the public realm.
Still, the public could benefit from more transparency when it comes to their health, and it doesn't get much more user-friendly than Consumer Reports-style ratings. The Department of Health and Human Services already allows patients to compare hospitals and nursing homes (as we wrote about earlier this year) on various quality measures. Why not provide this kind of information on providers, too?