Abstract T MP82: Can Patients Select the Best Hospital for Carotid Revascularization?
Introduction: Carotid revascularization guidelines have emphasized for the past two decades that the periprocedural complication rates should be monitored and made available to referring physicians. There has also been a movement in recent years towards greater transparency with regard to the communication of health outcomes directly to patients.
Objective: To evaluate the hypothesis that publicly available data for patients contemplating a carotid revascularization procedure would be sparse.
Methods: The Federal government’s Medicare Hospital Compare website (www.medicare.gov/hospitalcompare) was evaluated with regard to carotid endarterectomy (CEA) and carotid artery stenting (CAS). Information was sought regarding procedural volumes at 30 hospitals within 50 miles of a single metropolitan area. We also determined whether hospital or surgeon CEA or CAS complication rates were provided. Hospital characteristics were evaluated in relation to release of information.
Results: A 12 month data collection period was evaluated (2011-12). Information was available for CEA only (DRG codes 38 and 39, with and without complications or comorbidities). Eight of 30 hospitals (27%) provided procedural volumes for these two codes, nine hospitals (30%) provided partial data, and 13 hospitals (43%) did not provide any information. During the 12 month period, procedural volumes ranged from 12-56. No information was provided regarding hospital periprocedural stroke/death rates. No information was provided regarding individual surgeon outcomes. None of the four hospitals affiliated with a for-profit health system provided complete information and neither of two Veterans Affairs hospitals provided data on CEA volumes. No data was provided with regard to CAS volumes or outcomes.
Conclusions: Despite the importance of determining a hospital’s and surgeon’s track record with regard to CEA and CAS outcomes, the quality of information publicly available to patients (and referring physicians) is dismal. Almost half of the hospitals in this metropolitan area did not even provide CEA procedural volumes. Patients and referring physicians should be provided with higher quality information if they are to make informed medical decisions regarding CEA and CAS.
Author Disclosures: S. Chaturvedi: Consultant/Advisory Board; Modest; Boehringer-Ingelheim, Genentech, Merck. Research Grant; Significant; Pfizer.
- © 2015 by American Heart Association, Inc.