{"id":5943,"date":"2009-01-01T00:00:00","date_gmt":"2009-01-01T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/publicly-reported-provider-outcomes-the-concerns-of-cardiac-surgeons-in-a-single-payer-system\/"},"modified":"2023-06-14T19:29:55","modified_gmt":"2023-06-14T23:29:55","slug":"publicly-reported-provider-outcomes-the-concerns-of-cardiac-surgeons-in-a-single-payer-system","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/publicly-reported-provider-outcomes-the-concerns-of-cardiac-surgeons-in-a-single-payer-system\/","title":{"rendered":"Publicly reported provider outcomes: the concerns of cardiac surgeons in a single-payer system"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; Provider outcomes reports are an important part of quality improvement efforts. The positive and negative impact of such reports on the delivery of care has not been extensively explored.<\/p>\n<p><strong>Methods<\/strong> &#x2014; A survey of Ontario cardiac surgeons was performed in September 2003 to understand their concerns regarding performance reports. The questionnaire addressed the use of evidence-based practices, the impact of public-provider profiling on clinical practice and the improvement of current report cards. The survey was conducted with the distribution of a fiscal 2000\/2001 cardiac surgery report card.<\/p>\n<p><strong>Results<\/strong> &#x2014; There was a 95% (52 of 55 cardiac surgeons) survey response rate, of which 80% were high-volume surgeons with a case volume of more than 200 cases per year. Seventy-four per cent of surgeons had more than five years of experience. The majority of surgeons believed that performance reports influenced cardiologist referrals (84%) and patient choices (80%). A minority (48%) of surgeons believed that the reporting of inhospital mortality was very or extremely useful, but a majority (83%) believed mortality rates indicated the relative performance of a cardiac surgeon. The majority of surgeons believed that routine upcoding of data (84%) and inadequate risk adjustment (75%) were weaknesses of present performance reports. Surgeons were divided regarding whether the institutional performance should continue to be publicly reported (51% agreed with public reporting).<\/p>\n<p><strong>Conclusions<\/strong> &#x2014; In a single-payer system, performance reports breed provider concerns similar to those seen in market-driven systems including high-risk patient avoidance and upcoding of data. Regardless, providers recognize that institutional performance reports, irrespective of public or confidential reporting, are important in continuous quality improvement.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; Provider outcomes reports are an important part of quality improvement efforts. The positive and negative impact of such reports on the delivery of care has not been extensively explored. Methods &#x2014; A survey of Ontario cardiac surgeons was performed in September 2003 to understand their concerns regarding performance reports. The questionnaire addressed the [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[40,62,25],"migration-helper-qa-sample-set":[],"class_list":["post-5943","journal_article","type-journal_article","status-publish","hentry","topic-cardiovascular-disease","topic-health-services-research","topic-surgery"],"acf":{"citation":"Guru V, Naylor CD, Fremes SE, Teoh K, Tu JV. <em>Can J Cardiol<\/em>. 2009; 25(1):33-8.","source_url":"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2691878\/","ices_scientist":[1304],"site":[6733],"research_program":[6742],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"9D0E9D54-7BC5-45A8-8D56-35DAD0F4A795","sitecore_item_name":"Publicly-reported-provider-outcomes-The-concerns-of-cardiac-surgeons-in-a-single-payer-system","sitecore_field_values":"{\n  \"Title\": \"Publicly reported provider outcomes: the concerns of cardiac surgeons in a single-payer system\",\n  \"Short title\": \"Publicly reported provider outcomes\",\n  \"Citation\": \"<p>Guru V, Naylor CD, Fremes SE, Teoh K, Tu JV. <em>Can J Cardiol<\/em>. 2009; 25(1):33-8.<\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; Provider outcomes reports are an important part of quality improvement efforts. The positive and negative impact of such reports on the delivery of care has not been extensively explored.<\/p>n<p><strong>Methods<\/strong> &mdash; A survey of Ontario cardiac surgeons was performed in September 2003 to understand their concerns regarding performance reports. The questionnaire addressed the use of evidence-based practices, the impact of public-provider profiling on clinical practice and the improvement of current report cards. The survey was conducted with the distribution of a fiscal 2000\/2001 cardiac surgery report card.<\/p>n<p><strong>Results<\/strong> &mdash; There was a 95% (52 of 55 cardiac surgeons) survey response rate, of which 80% were high-volume surgeons with a case volume of more than 200 cases per year. Seventy-four per cent of surgeons had more than five years of experience. The majority of surgeons believed that performance reports influenced cardiologist referrals (84%) and patient choices (80%). A minority (48%) of surgeons believed that the reporting of inhospital mortality was very or extremely useful, but a majority (83%) believed mortality rates indicated the relative performance of a cardiac surgeon. The majority of surgeons believed that routine upcoding of data (84%) and inadequate risk adjustment (75%) were weaknesses of present performance reports. Surgeons were divided regarding whether the institutional performance should continue to be publicly reported (51% agreed with public reporting).<\/p>n<p><strong>Conclusions<\/strong> &mdash; In a single-payer system, performance reports breed provider concerns similar to those seen in market-driven systems including high-risk patient avoidance and upcoding of data. Regardless, providers recognize that institutional performance reports, irrespective of public or confidential reporting, are important in continuous quality improvement.n<\/p>n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2691878\/\" title=\"opens external link\">View full text<\/a><\/p>\",\n  \"Keywords\": \"{95BBE8DE-D10D-45F0-8843-79306044E334}|{9F514AF9-2526-48FE-8414-54C443CF99AD}|{92E2791D-5DAB-4244-8A85-434D524D9A12}\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{545C70EB-0A3F-4646-A0F5-509EB7E15CF6}|{956599EC-5699-41D3-9375-E0B6C25B12D5}\",\n  \"Posted Date\": \"20090101T000000\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2009\/January\/Publicly-reported-provider-outcomes-The-concerns-of-cardiac-surgeons-in-a-single-payer-system"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Publicly reported provider outcomes: the concerns of cardiac surgeons in a single-payer system<\/title>\n<meta name=\"description\" content=\"Background &#x2014; Provider outcomes reports are an important part of quality improvement efforts. 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