The effects of New York’s bypass surgery provider profiling on access to care and patient outcomes in the elderly
Why the study?
Critics suggested that New York provider profiling for bypass surgery reduced in-state procedural access and increased out-of-state transfers without improving patient outcomes.
Does provider profiling for bypass surgery affect access to care and 30-day mortality in elderly patients?
Population
Medicare patients aged 65 years or older in New York and nationwide
Comparison
New York vs the rest of the nation before and after provider profiling initiation
Design
Observational study using national Medicare data
Follow-up
30-day
Authors
Discussion
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Member takes
Implication
Allays fears of access denial for elderly under public reporting; leaves open whether it drives outcome improvements or reflects other factors.**[[1]](https://pubmed.ncbi.nlm.nih.
Structured PICO
Does provider profiling for bypass surgery affect access to care and 30-day mortality in elderly patients?
P
Population
Elderly Medicare patients (aged ≥65 years) in New York and nationwide undergoing bypass surgery or with myocardial infarction between 1987 and 1992
I
Intervention
New York's provider profiling program (provider-specific bypass surgery mortality reports) initiated in 1989
C
Comparator
Pre-program period (1987) and nationwide Medicare patients
O
Outcome
Out-of-state bypass surgery rates, in-state procedure use following myocardial infarction, and 30-day mortality rates following bypasshard clinical
Provider profiling for bypass surgery in New York was associated with significantly improved 30-day mortality without decreasing access to care or increasing out-of-state transfers.
Cite This Study
Peterson et al. (1998) studied this question.