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September 18, 2019

Death to Mortality as a Reported Percutaneous Coronary Intervention Quality Metric

Author Affiliations
  • 1Cardiovascular Institute, Carilion Clinic, Virginia Tech Carilion School of Medicine, Roanoke
JAMA Cardiol. 2019;4(11):1065-1066. doi:10.1001/jamacardio.2019.3232

Public reporting of health care data is not new. Its roots can be traced back to Florence Nightingale, who published mortality rates at British military hospitals during the Crimean War in the hopes that public transparency would lead hospitals with high mortality rates to improve.1 Fast forward to 2005, when the Centers for Medicare & Medicaid Services launched the Hospital Compare website to help patients make decisions about where to get health care and encourage hospitals to improve the quality of care that they provide.2 Additional mandates for the development of public reporting are contained in the Patient Protection and Affordable Care Act enacted in 2010. Public reporting programs continue to proliferate and now exist in many forms, with reports from (1) federal and state agencies, (2) payers and business consumer groups, (3) databases maintained by professional organizations, (4) independent organizations using their own proprietary analysis and rating schemes, (5) groups focusing on the cost of care, and (6) public websites where patients can rate their personal experiences with physicians. The strongest justification for public reporting is the public’s right to know about the quality of care that they are likely to receive. However, for any public reporting program to achieve this goal, the reporting process must be fair and accurate and include meaningful metrics that the public can understand. Although public reporting is intended to help patients make better decisions and identify poor performers, many criticisms have been stated, and data that support the value of public reporting are sparse.3

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