- Public reporting of mortality outcomes for coronary revascularization has resulted in significant risk aversion among PCI operators, potentially reducing patient care quality.
- After excluding refractory cardiogenic patients from publicly reported PCI data, New York operators were more likely to perform high-risk PCI for patients with acute coronary syndrome complicated by cardiogenic shock. This change resulted in a trend toward improved mortality.
Public reporting was originally designed to build public trust and improve care quality; however, there is some speculation that the reporting of treatment outcomes may lead to intervention avoidance, particularly for high-risk patients requiring percutaneous coronary intervention (PCI). This risk avoidance may negatively impact public health by reducing PCIs performed for at-risk patients.In 2006, the New York State Department of Public Health began excluding refractory cardiogenic shock (CS) patients from public reporting of PCI in an effort to combat risk avoidance.A study published in JAMA Cardiology examined the effects this policy change had for patients
with acute myocardial infarction (AMI) complicated by CS (n=45,977).1
Specifically, the change in rates of coronary revascularization and in-hospital mortality for New York AMI patients (n=11,298) complicated by CS following the exclusion of CS from public reporting were evaluated. Continue readingChanges in Public Reporting and Their Impact on Treatment and Outcomes of Acute Myocardial Infarction
Dr. James McCabe of the University of Washington uses case examples to discuss public reporting and outcomes data and how it affects high-risk PCI programs and procedures. Dr. McCabe presented this at the Expanding Your Practice to Include Complete Revascularization in Higher-Risk Indicated Patients sponsored by the Cardiovascular Research Foundation course held in Seattle this … Continue reading “The Current & Future State of High Risk PCI in a World of Increasing Public Scrutiny”