Study finds reporting heart procedure results can limit use

Oct 11 2012

The research in the Journal of the American Medical Association shows that in states that report outcomes from procedures to open blocked arteries, patients are less likely to get the treatment. However, they found no differences in patient survival.

Los Angeles Times: For Heart Patients, Medical Disclosure Can Limit Treatment
Heart attack patients in states that require healthcare providers to report the outcomes of procedures to open blocked arteries are less likely to receive those live-saving treatments than similar patients in states without public reporting mandates, according to a new study. The disparities in care, however, appeared to have little effect on patient survival rates. The analysis, based on nearly 100,000 Medicare patients in 10 states, comes amid a nationwide push for greater transparency in how doctors and hospitals measure up against one another (Zarembo, 10/9).

Reuters: Fewer Heart Stents In U.S. States Reporting Outcomes
In what might be an unintended consequence of health care improvement efforts, older heart attack patients seem less likely to get stents in the U.S. states that require hospitals to report the outcomes of such procedures, according to a new study. Some believe public reporting allows patients to pick the best hospitals while encouraging hospitals to perform better, according to the researchers. But some fear such reporting also discourages doctors from performing risky but necessary procedures (Seaman, 10/9).

Healthday/Philadelphia Inquirer: State Regulations Tied To Drop In Common Heart Procedure
If you suffer a serious heart attack, your medical treatment could depend on where you are when you have it. If you're in a U.S. state with mandatory hospital public reporting, you may be less likely to get angioplasty to treat a blocked artery than if you were in a state without such data collection, a new study suggests (10/9).

Kaiser Health News: Revealing Angioplasty Outcomes Didn't Improve Patient Mortality: Study
In the 23 years since New York State began publishing hospital death rates of coronary artery-bypass graft patients, the number of publicly reported outcome measures has proliferated. There are now 258 public reports on health care quality available around the country, according to the Robert Wood Johnson Foundation. Researchers are still studying what impact this transparency movement has had. The latest such effort, published Tuesday by the Journal of the American Medical Association, looked at three states that publicly report the results of heart attack patients receiving angioplasties, stents and other percutaneous coronary interventions (Rau, 10/9).

Another journal also takes a look at how medical practice is affected by research into effectiveness.

Medpage Today: Effectiveness Research Slow To Change Practice
Comparative effectiveness research is slow to change clinical practice, and separate papers published in the October issue of Health Affairs seek to explain why. Financial barriers such as fee-for-service models, biases, and limited use of tools to aid in treatments better aligned with evidence all prevent more cost-effective, results-driven treatments from taking root, wrote Justin Timbie, PhD, a health policy researcher at the RAND Corporation in Arlington, Va., and colleagues. … In the second paper, [researchers] examined the correlation between the publication of two large clinical trial results showing arthroscopic debridement and lavage don't benefit patients with arthritis of the knee, and changes in the frequency of the procedure. While the number of procedures dropped after the first data were published in 2002, results found arthroscopic debridement and lavage dropped also when payers stopped covering the procedure (Pittman, 10/9).