Public Reporting of PCI Outcomes and Quality of Care:  One Step Forward and New Questions Raised

In 1987, Medicare for the first time released mortality statistics for coronary artery bypass graft (CABG) surgery and the following year released mortality statistics for percutaneous coronary intervention (PCI). At the same time, New York State began collecting mortality data for CABG by hospital and individual surgeon. The New York State mortality statistics were published in a landmark article in the December 18, 1991, issue of Newsday. After initial refusal by New York State to release those statistics, the Supreme Court ordered the state, under the Freedom of Information Act, to release the data to Newsday, marking the first time that mortality data by hospital and by surgeon were published in a newspaper. In that same year, a report from the Northern New England Cardiovascular study group and a report from Pennsylvania were published in JAMA.^1- 2 Both reports showed that differences in mortality for CABG surgery across institutions could not be explained just by disease severity and comorbid conditions. The reports stimulated a vivid debate, which provided a starting point for what followed over the next 2 decades. Since then, public reporting of quality data and outcomes data has become a mainstay of contemporary health care delivery.