Thursday, December 07, 2006

Not Quite Ready

Massachusetts health authorities have decided to publish mortality data for each of the 55 heart surgeons who perform cardiac bypass operations in the Commonwealth.

According to the article in the December 6, 2006 issue of the Boston Globe that reported this decision, this same data has been published in Massachusetts since 1991, but by hospital without identifying surgeons. During that time, one hospital temporarily suspended its cardiac surgery program because of high mortality and another suspended a surgeon, presumably for the same reason.

The article indicated that the first report will include some “outliers;” i.e., surgeons with high rates, but that those surgeons no longer practice surgery in Massachusetts. (Mortality rates will be reported as three-year moving averages and the data will be almost two years old by the time they are released.)

So if reporting by institution was working, why identify individual surgeons – particularly when an “outlier” not dealt with by a hospital could be killing people for two years before the numbers become public?

The authority interviewed was quoted as attributing the decision to “….the growing push by employers, insurers, the federal Medicare program, and the Romney administration to more fully disclose medical care data.”

My own interpretation is that while both logic and evidence indicates that properly run hospitals are our best assurance of quality health care, we are still not quite ready to put our faith in institutions rather than in individuals.

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