Mandatory reporting may restrict high-risk care

Researchers compared angioplasty case selection by cardiologists in New York, which has mandatory outcome reporting, and Michigan, which does not.

By Myrle Croasdale, AMNews staff. June 27, 2005.

A new study reinforces previous work showing that public reporting of angioplasty outcomes leads cardiologists to avoid high-risk patients

"Public reporting has the unintended effect of biasing physicians against giving care to those who are the highest risk," said Mauro Moscucci, MD, lead author of "Public Reporting and Case Selection for Percutaneous Coronary Interventions" published in the June 7 issue of Journal of the American College of Cardiology. This can lead to patients missing out on beneficial care, he said.

In addition, Dr. Moscucci found that physicians did not actually earn lower performance scores by having a larger number of high-risk patients.

"Our study suggests that the risk adjustment methodology is pretty robust," he said.

Dr. Moscucci and his colleagues at the University of Michigan Health System and the State University of New York-Stony Brook School of Medicine looked at registries of angioplasty results in Michigan, which has no public reporting system, and compared them with New York's registry results, where reporting is mandatory.

They found that the patients treated in Michigan had a significantly higher number of risk factors than those in New York. Also, Michigan's cardiologists did angioplasties for patients with cardiogenic shock, acute myocardial infarction and cardiac arrest more frequently than New York's cardiologists did.