JSM 2004 - Toronto

Abstract #301086

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Activity Number: 397
Type: Topic Contributed
Date/Time: Thursday, August 12, 2004 : 8:30 AM to 10:20 AM
Sponsor: Section on Bayesian Statistical Science
Abstract - #301086
Title: The Role of Information in Medical Markets: An Analysis of Publicly Reported Outcomes in Cardiac Surgery
Author(s): Mary Beth Landrum*+
Companies: Harvard Medical School
Address: 180 Longwood, Boston, MA, 02110,
Keywords:
Abstract:

Provider profiling has been urged by many as a fundamental step in medical care reform. Despite the building momentum for this strategy, the underlying premise of profiling--that disseminating information about provider quality will lead to improved quality of care--has yet to be established. We undertake a new approach aimed at resolving this fundamental controversy. Using a longitudinal data set containing all individuals who underwent CABG in a hospital in New York State over a nine-year period, we consider how report cards affect the behavior of individual providers, specifically providers who are publicly identified as being significantly better or worse than their peers. We use Bayesian longitudinal hierarchical regression models to examine patterns in volume, average severity, and mortality following surgery, adapting models previously used to profile providers using longitudinal data. Our analysis addresses three intended goals of provider profiling.

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