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The Society of Thoracic Surgeons voluntary public reporting initiative: the first four years
David Shahian1, Frederick Grover2, Richard Prager3, Fred Edwards*4, Giovanni Filardo*5, Sean O'Brien*6, Xia He*6, Anthony Furnary*7, J. Scott Rankin*8, Vinay Badhwar*9, Joseph Cleveland*2, Franco Fazzalari*3, Mitchell Magee*10, Jane Han*11, Jeffrey Jacobs*12
1Massachusetts General Hospital, Boston, MA;2University of Colorado Anschutz School of Medicine, Aurora, CO;3University of Michigan, Ann Arbor, MI;4University of Florida, Jacksonville, FL;5Baylor Scott & White Health, Dallas, TX;6Duke Clinical Research Institute, Durham, NC;7Starr-Wood Cardiac Group, Portland, OR;8Vanderbilt University, Nashville, TN;9University of Pittsburgh, Pittsburgh, PA;10HCA Medical City Dallas Hospital, Dallas, TX;11Society of Thoracic Surgeons, Chicago, IL;12Johns Hopkins All Children’s Heart Institute, Saint Petersburg, FL

Objective: We report initial findings of a voluntary national public reporting program using Society of Thoracic Surgeons (STS) clinical data and quality metrics for index procedures.
Methods: In 9 consecutive semi-annual STS performance rating periods (2010 -2014), we studied public reporting participation rates as well as the distributions of risk-adjusted mortality rates, composite performance scores (risk-adjusted morbidity and mortality for each cardiac operation, plus two process measures for CABG), star ratings, and volumes for reporting versus non-reporting sites.
Results: Among 8,929 unique STS Database participant rating opportunities (generally hospital/program level), sites were classified as low performing in 916 (10.3%) instances, average in 6,801 (76.2%), and high performing in 1,212 (13.6%). Overall public reporting participation rates ranged from 23.8% in 2010 to 41.8% in October 2014. Risk- adjusted mortality rates for isolated CABG were consistently lower in public reporting sites than in non-reporting sites (e.g., 2.1% versus 2.4%, P = 0.03, in the first rating period of 2014). Composite performance scores and star ratings were also superior in the former (4.5% low performing and 23.2% high performing, versus 13.8% low performing and 7.6% high performing, respectively). STS public reporting sites had higher mean annualized CABG volumes than non-reporting sites (169 versus 145, p <0.0001), and high performing programs had higher mean CABG volumes (n = 241) than average (n = 139) or low performing (n = 153) sites.
Conclusions: Participation in the STS voluntary public reporting program has nearly doubled over 4 years. Reporting programs have significantly higher volumes and performance.


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