A star-based system for rating the isolated coronary artery bypass surgery performance of more than 200 U.S. thoracic surgery practices went live on the Consumer Reports Health Web site this morning, September 7. The Society of Thoracic Surgeons provided the data for and created the ratings, based on a database it maintains for about 950 of the roughly 1,000 U.S. thoracic surgery practices that perform coronary artery bypass grafting (CABG).
The current list of 221 U.S. surgery practices that agreed to participate in the rating system and data release (about a quarter of the total number that could be listed) fell substantially short of the 300 or more that the STS had hoped would be initial participants when the society promoted the program at their annual meeting last January.
Another notable, and perhaps predictable, development is that the 221 practices that have so far opted to participate skews sharply toward practices that received the best rating. The ratings use a star system, with three stars indicating above average performance, two stars denoting average practice, and one star for practices with below-average performance and outcome results. The 221 participating practices break down this way: 50 with three stars, 166 with two stars, and five with one star.
The listed star ratings are for overall practice and outcomes performance, but the ratings also include star assignments for each of the four individual parameters that make up the overall rating: 30-day survival; in-hospital complications (extended ventilator time, surgical-site infection, renal failure, stroke, or need for additional surgery); use of at least one internal mammary-artery graft; and the percent of CABG patients who receive a beta-blocker before surgery and receive lipid-lowering drug and aspirin following surgery.
Also today, the October issue of Consumer Reports went on sale with an article that includes the names and locations of the 50 three-star CABG practices.
The roughly 700 U.S. thoracic surgery practices that declined to participate in the inaugural listing will get another chance in the next few months to sign on for the first update to the listings next year, said Dr. John Santa, director of the Consumer Reports Health Ratings Center.
—Mitchel Zoler (on Twitter @mitchelzoler)