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)
Hannan
1994 21
(Good)
1. Study Purpose
and/or a priori
Hypothesis:
1) To examine
changes in the riskadjusted
CABG
outcomes among
providers that
occurred during
1989-1992 as a
function of the riskadjusted
mortality
in 1989.
2) To examine
changes in the
volume of patients
undergoing CABG
as a function of the
performance of
providers in 1989.
2. Geographic 3. Study
Location design
New York Interrupted
Time Series
4. Sample/ 5. Primary
Population Comparison 6. Outcomes
30 providers Baseline: Three Intra-group
(hospitals and different groups of ten changes in RAMR:
surgeons) created using RAMR RAMR for each
performing prior to public tercile (Group 1=
CABG surgeries release. Then look at lowest RAMR,
in New York performance before Group 2 = middle
state
and after public RAMR, Group 3 =
report.
Highest RAMR) in
initial period (1989
for hospitals; 1989
to 1990 for
surgeons)
compared to
RAMR for same
tercile in 1992.
H-10
For surgeons:
Same breakdown
of terciles, but
groups 1 and 2
have an N of 32
each, while group
3 has an N of 31
Outlier status
(high outliers, nonoutliers,
and low
outliers, with low
outliers having
significantly lower
than expected
mortality rates)
Volume of
procedures:
tracked using
same tercile and
outlier groupings.
7. Public
Report Name
and
Description*
8. Context:
Environment
Characteristics
NY CSRS Public Reporting of
CABG for Hospitals
and Surgeons
required in NY