Hospital Report Cards Seldom Lead to Improved Cardiac Care

Study discerns no significant improvement in care for heart failure or heart attack
By Jeff Muise
HealthDay Reporter

WEDNESDAY, Dec. 2 (HealthDay News) -- Issuing public report cards on hospitals did not result in significant improvements in cardiac care, according to a Canadian study in the Dec. 2 issue of the Journal of the American Medical Association. The study was released early online to coincide with its presentation at the American Heart Association Scientific Sessions, held from Nov. 14 to 18 in Orlando, Fla.

Jack V. Tu, M.D., of the Institute for Clinical Evaluative Sciences in Toronto, and colleagues studied the impact of public report cards on 86 hospitals in Ontario, Canada. The hospitals were randomized to have report cards on their performance in 1999 to 2001 released to the public early or delayed. The study looked at the impact of the report card release on care for acute myocardial infarction (AMI) and congestive heart failure (CHF), including composite and individual care indicators and mortality.

The researchers found no significant improvements in either the composite AMI care indicator or the composite CHF care indicator from the early publication of the hospital report card. During follow-up, the mean 30-day AMI mortality rates declined 2.5 percent for the hospitals in the early report card release group compared with the delayed group, but CHF mortality rates were not significantly altered.

"In this controlled experiment, we observed that the public release of hospital-specific, clinical data on a set of well-established cardiac quality indicators did not significantly improve mean hospital performance on either a composite AMI or CHF process-of-care indicator in the early feedback group compared with the delayed feedback group," the authors write.

One study author reported being an advisor for a lifestyle and disease management company.

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