The ratings of inconsistent cardiac surgery may confuse patients
The ratings of inconsistent cardiac surgery may confuse patients
(Reuters Health) - Publicly available ratings of hospital quality in the US UU For cardiac surgery they vary so much that they can be more confusing than useful for patients trying to choose the best place to have a procedure, according to the researchers.
Of the more than 600 hospitals on a list of "The best hospitals for cardiac surgery" of the United States and World Report, only two of its facilities with the best rating for a common cardiac procedure were also rated with the same surgery by Healthgrades, The Society of Thoracic Surgeons and the Centers for Medicare and Medicaid Services, the study team reports in the Journal of the American College of Surgeons.
"Patients are increasingly using public classifications of hospitals and surgeons to choose where to look for surgical care," said the study's lead author, Dr. Ravi Ghanta, chief of cardiac surgery at Ben Taub General Hospital in Houston, Texas.
"Hospital organizations also use the ratings to promote patients and the community," Ghanta told Reuters Health by e-mail. "The inconsistency in these ratings could confuse, rather than clarify, decision making for patients."
Ghanta and his colleagues compared the ratings of the 602 hospitals on the list of best hospitals for cardiac surgery of US News & World Report 2016-2017 with ratings on three other publicly available and widely used hospital quality databases: the Society of Thoracic Surgeons' Cardiac Surgery for Adult Database, the Hospital Comparison List of the Centers for Medicare and Medicaid Services and Healthgrades, a media company.
The researchers analyzed quality classifications for two common procedures, coronary artery bypass and aortic valve replacement. Since the four systems assign hospitals to one of the three quality categories, the researchers translated each set of scores into a consistent score that reflects performance better than the national average, average, or worse than the average.
They found that the four systems had very different rating distributions, with ratings for coronary artery bypass ranging from 50% to 85% of the time, and for aortic valve replacement, between 50% and 73% of the time.
The researchers point out that the news and the global report of the USA. UU They tend to rate hospitals with a higher performance than the other databases. The lists of the Society of Thoracic Surgeons and Centers for Medicare and Medicaid Services tend to coincide best with each other for coronary artery bypass. For the replacement of the aortic valve, the lists of the Society of Thoracic Surgeons and Healthgrades tend to coincide with the highest frequency.
Only the two hospitals were rated as high performing by the four classification systems for coronary artery bypass grafting, and three were classified in this category by the four lists for aortic valve replacement. In general, hospitals with high ratings were located mainly in California, Florida and New York.
The disagreements between the rating systems were sometimes crude, for example, 13 hospitals were classified as better than average employees in both procedures according to a rating system and worse than the average according to another. And no hospital was rated in the four rating systems as underperforming for any of the procedures.
"This disagreement is due to different data sources and qualification methodologies," Ghanta said. "Each rating system qualifies on a different curve."
It is likely that patients are not familiar with these nuances between systems, he added. The Society of Thoracic Surgeons system, for example, is based on an audited and risk-adjusted database that has been developed in recent years to focus on improving quality. Many cardiac surgeons see this as the "gold standard," he added.
"Rating systems are everywhere, and several studies have shown that hospitals use these ratings as a marketing strategy," said Dr. Nicholas Osborne, a surgeon and researcher at the University of Michigan in Ann Arbor, who did not participate. in the study.
"We are in real danger when we begin to replace quality measures with rating systems that may not measure or define what quality should be," he said in a telephone interview. "For example, the quality may be different for different procedures."
He added that future studies should investigate the best ways to help patients make decisions and learn about the surgical results they want to know.
"The field of marketing has always understood how to transmit information to consumers, but medical care has not worked well," Osborne said. "We need to know what is important for patients and how to talk to them about it."
SOURCE: bit.ly/2yI5Dv1 Journal of the American College of Surgeons, online October 22, 2018.
.
!function(f,b,e,v,n,t,s)
{if(f.fbq)return;n=f.fbq=function(){n.callMethod?
n.callMethod.apply(n,arguments):n.queue.push(arguments)};
if(!f._fbq)f._fbq=n;n.push=n;n.loaded=!0;n.version='2.0';
n.queue=[];t=b.createElement(e);t.async=!0;
t.src=v;s=b.getElementsByTagName(e)[0];
s.parentNode.insertBefore(t,s)}(window, document,'script',
'https://connect.facebook.net/en_US/fbevents.js');
fbq('init', '369524843414444');
fbq('track', 'PageView');
.
SOURCE LINK ERESVIRAL.COM https://www.beviral.online
Comentarios
Publicar un comentario