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Eur J Cardiothorac Surg 2003;23:607-608
© 2003 Elsevier Science NL

Editorial comment

On the fine balance between the completeness of clinical data and the effective use of outcomes data

Cattedra di Cardiochirurgia, Università di Roma Tor Vergata, European Hospital, via Portuense 700, 00149 Rome, Italy

Received 18 December 2002; accepted 20 December 2002.

^* Tel.: +39-6-659-759; fax: +39-6-6597-5724
e-mail: depauli@tin.it

Key Words: Coronary artery bypass surgery • Discharge abstract data • 30-Day mortality

The first 20% of the full text of this article appears below.

There is no doubt that the publication of performance data of different cardiac surgery units is an effort toward an improvement of the quality of care to better serve the final consumer (i.e. the patient). Quality comparison is in fact mostly intended to stimulate internal quality improvement efforts by physicians and health care providers but is also used as a mean to control and contain costs. Nonetheless, several implications are related to such reports and interpretation of the data are often not univocal and subject to debate. The responsibilities of such reports are important because they can affect future decisions making at several levels. While these studies are expected to positively influence the delivered quality of care as demonstrated in some of the pioneering studies in this field [1], on the other hand they could negatively influence the decision whether or not operating on sicker or elderly patients, with restriction from surgical activities for resident in teaching hospitals, or the decrease of operating privileges for less experienced, low-volume surgeons. Health care providers of good performing hospitals would probably use such information to attract more patients or use it as a benchmark for obtaining more resources and financial support. Conversely, publications of data of poor performing hospitals would probably have a negative impact on citizens confidence and on the professional . . . [Full Text of this Article]