Malpractice News

June 24, 2013

Death rate report affects patient selection

If you had to undergo surgery, you’d want to be treated at the facility has the best outcomes for your particular surgery, right? That seems reasonable. For this very reason, however, some patients are getting turned away after death reports are released. A recent study focused mainly on patients who needed a common type of heart surgery, though they hypothesize this same type of thing might be happening with other procedures as well.

Stenting is a common procedure

The placement of a stent has become fairly routine. During the procedure, a doctor inserts a balloon-tipped catheter into the patient’s bloodstream and then threads it into a vein in the heart that has narrowed. The balloon is inflated and then the stent—a tiny mesh tube—is inserted to keep the vessel open. On average, the death rate associated with this surgery is 1.6%. This statistic is available in the public record in order to “give the public more information on the healthcare it’s receiving” and to “encourage hospitals to adopt best practices.”

Statistics drop after death rates released

An unforeseen and negative effect of hospital reporting transparency has been that once a hospital has been identified as a statistical outlier, doctors at that institution are more likely to turn away high risk cases. After death rates were published, hospitals that previously had high death rates dropped to 1.1%, which the researchers inferred implies that “the patients being sent for stenting at ‘outliers’ were not as sick as those at other hospitals."

Dr. Gregory Dehmer, a medical professor at Texas A&M Health Science Center said, “I think the unintended consequence here is . . . there could clearly be a high-risk patient who would benefit from having a high-risk procedure [who doesn't get it].”


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