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September 2016

The Complicated Calculus of Publicly Reporting Mortality After Percutaneous Coronary Intervention

Author Affiliations
  • 1Herbert and Sandi Feinberg Interventional Cardiology and Heart Valve Center at Columbia University Medical Center/New York-Presbyterian Hospital, New York, New York
  • 2Cardiovascular Research Foundation, New York, New York
  • 3Associate Editor, JAMA Cardiology
  • 4Ann Arbor Veterans Affairs Center for Clinical Management and Research, Ann Arbor, Michigan
  • 5Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Health System, Ann Arbor
JAMA Cardiol. 2016;1(6):637-638. doi:10.1001/jamacardio.2016.1207

With transparency touted as a fundamental component of quality improvement in an emerging era of value-based health care, the call for increased reporting of procedural outcomes is burgeoning. Public reporting of coronary revascularization outcomes has been available in several states for several decades, and there are proposals to expand it more broadly. Fundamentally, the interest in public reporting reflects a desire to both improve and incentivize high-quality care. Another purported benefit is to assist patients in the selection of physicians and hospitals. However, for public reporting of procedural outcomes to be useful, it is imperative that the measure—in this case mortality—be homogeneously representative of overall procedural quality. Furthermore, “unintended consequences” must be addressed when advocating for public reporting as an essential component of value-based health care.

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