5. Public Reporting as a Quality Improvement Strategy

Table H1. Hospital quantitative studies: columns 1-8 of 18 (pages H-1 to H-18) (continued)
Author, Year
(QA)
Bridgewater
2007 6
(Good)
Carey 2006 7
(Fair)
1. Study Purpose
and/or a priori
Hypothesis:
To study changes
in coronary artery
surgery in years
spanning
publication of
cardiac surgery
mortality data in
the UK.
To study the
impact of public
reporting and
changes in the
incidence of PCI
and CABG
procedures in
California.
2. Geographic 3. Study
Location design
Northwest Interrupted
England Time Series
California One Group
Pretest
Posttest
4. Sample/ 5. Primary
Population Comparison 6. Outcomes
Data collected Pre-public reporting Observed
on 25,730 period: April 1997 to Mortality: Any in-
consecutive March 2001; Posthospital death
patients public reporting Predicted
undergoing period: April 2001- Mortality: Risk
adult cardiac March 2005
adjusted mortality
surgery (isolated
based on
coronary artery
surgery)
EuroSCORE.
between April 1,
Changes in the
1997 and March
number of very
31, 2005 in the
high risk patients
northwest of
undergoing
England.
coronary artery
surgery: Stratified
risk spectrum of
patients
undergoing
surgery: low risk
=6
EuroSCORE, and
very high risk
Hospitals in
California
performing
CABG and PCI
operations
Pre public report:
1998-2002 Post
public report: 2003-
2004
Hospitals in both
groups: N = 115
Hospitals performing
CABG and PCI:
N~120 (6 stopped
performing during
study period and 7
started performing
sometime during
study period)
H-3
>=11 EuroSCORE
Mortality: Inhospital
death and
30 day mortality or
readmission for
repeat procedure
Volume: Number
of given
procedures
(CABG vs PCI)
7. Public
Report Name
and
Description*
Multiple
Reports on
named
Surgeon and
Hospital
outcomes in
UK
California
Coronary
Artery Bypass
Graft Mortality
Reporting
Program
8. Context:
Environment
Characteristics
Policy requiring
public reporting of
hospital specific
morality data
Public reporting prior
to 2002 voluntary,
after mandatory in
CA