Study shows mandatory reporting cuts down on angioplasty procedures

Patients treated for acute heart attack may undergo an angioplasty procedure and receive a coronary artery stent.
Syracuse (WSYR-TV) - Patients treated for acute heart attack may undergo an angioplasty procedure and receive a coronary artery stent.

Currently, some US states are mandated to publicly report the outcome of those procedures.

A new study examined if patients in states with mandatory outcome reporting were less likely to receive such procedures than patients in states that do not have mandatory reporting of such outcomes.

Time is crucial after a patient has a heart attack. Interventions such as angioplasty and implanting a stent to open blocked arteries are potentially life saving procedures. Massachusetts, New York, and Pennsylvania are required to publicly report the outcomes of these procedures.

“That makes hospitals incented to improve and it also gives consumers a chance to look at that information and try to go to the best possible hospital,” said Dr. Karen Joynt.

But some say making this information public could cause hospitals to avoid taking care of the sickest patients.

“These procedures can sometimes be lifesaving and we really don’t want there to be any incentive for a hospital to not provide one of these procedures if it isn’t necessary,” said Joynt.

Joynt from the Harvard School of Public Health and co-authors studied almost 50,000 Medicare patients in Massachusetts, New York, and Pennsylvania treated for heart attacks.

Researchers compared them to similar patients in seven other regional non-reporting states.

"Patients having heart attacks in public reporting states had about 20 percent lower odds of receiving one of these procedures than patients in other states,” Joynt said. "We didn't see any big changes in mortality across these groups suggesting that some of the procedures that were forgone were probably futile but some of the procedures were probably necessary."

Massachusetts started public reporting in 2005.

"In Massachusetts prior to public reporting rates of this procedure were about the same as they were in the rest of the country but after public reporting kicked in we saw that that rate started to fall. Massachusetts in particular has done a lot of work to try to mitigate that risk and try to help physicians and hospitals feel comfortable taking care of sick patients,” Joynt said.

Researchers say the federal government already publicly reports on outcomes for pneumonia, heart failure, heart attacks, and some surgeries.

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