Doctors May Avoid Performing PCI Due to Public Reporting
WEDNESDAY, May 16, 2018 -- Current percutaneous coronary intervention (PCI) public reporting programs could have negative effects, with physicians avoiding PCI in high-risk patients, according to a study published online May 9 in JAMA Cardiology.
Daniel M. Blumenthal, M.D., from Massachusetts General Hospital in Boston, and colleagues administered an online survey to eligible interventional cardiologists in Massachusetts and New York. Physicians were surveyed regarding PCI performance, including the reported rate of avoidance of performing PCIs in high-risk patients. One hundred forty-nine of 456 physicians responded.
The researchers found that participants had higher annual PCI volumes among Medicare patients than non-participants in 2014 (median, 31 versus 17). Sixty-five percent of the participants reported avoiding PCIs on at least two occasions out of concern that a bad outcome would negatively impact their publicly reported outcomes. Fifty-nine percent reported that they were sometimes or often pressured by colleagues to avoid PCIs due to concerns about the patient's risk of death. The odds of PCI avoidance were lower with more years of experience practicing interventional cardiology, after multivariable adjustment.
"Coordinated efforts by policy makers, health systems leadership, and the interventional cardiology community are needed to mitigate these unintended consequences," the authors write.
Several authors disclosed financial ties to pharmaceutical and medical device companies, including Abiomed, which partially funded the study.
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Posted: May 2018