The Downside of Transparency
Can the publication of hospital mortality rates create perverse incentives for physicians?
Public reporting of hospital death rates may be pushing Massachusetts cardiac specialists to treat some very sick heart patients less aggressively, sparking a debate among health officials and doctors over whether patients are being spared unnecessary and costly end-of-life treatment or denied procedures that might save their lives.
Very interesting post.
This is why the system for reporting needs to originate on the demand side of the market, not on the supply side.
There are a lot of potential problems with this approach including getting good data, how to standardize it, and how to prevent the focus on mortality from denying treatment to those likely to die and screw up a hospital’s ratings.
The New York State cardiac surgery report card has been operating for a while now and these problems are far from settled. It is depressing that Massachusetts doesn’t seem to have learned from the New York experience. For a comprehensive review of the problems associated with the New York State cardiac surgery report cards, and by extension all such performance measures, see http://ats.ctsnetjournals.org/cgi/reprint/72/6/2155.