Why the study?
Public reporting of TAVR outcomes by U.S. News & World Report began in August 2020, but the impact of these ratings on case selection had not been studied.
Does the public reporting of TAVR outcomes by USNWR reduce the selection of high-risk patients at lower-rated hospitals?
Population
138,147 prerating and 50,650 postrating Medicare fee-for-service beneficiaries undergoing TAVR at 618 hospitals
Comparison
Lower rated hospitals (average or below average) vs high-performing hospitals before and after ratings release
Design
Difference-in-difference observational analysis
Key result
Lower USNWR hospital TAVR ratings were associated with a significantly greater decline in patient Elixhauser comorbidity scores compared with higher-rated hospitals (difference -0.48; P<0.0001).
Authors
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Public reporting may foster risk aversion at lower-rated TAVR hospitals; leaves open effects on access and outcomes.
Observational (n=188,797)
Yes
Does the public reporting of TAVR outcomes by USNWR reduce the selection of high-risk patients at lower-rated hospitals?
Mean Difference: -0.48 (95% CI -0.66–-0.31)
p-value: p=< 0.0001
Public reporting of TAVR outcomes by USNWR is associated with risk aversion, leading to a significant decline in high-risk patients undergoing TAVR at lower-rated hospitals.
Yang et al. (2025) conducted an observational in Transcatheter aortic valve replacement (n=188,797). Lower USNWR hospital TAVR ratings vs. High-performing hospitals was evaluated on Patient risk profile (Elixhauser comorbidity score) (Difference-in-difference -0.48, 95% CI -0.66 to -0.31, p=< 0.0001). Lower USNWR hospital TAVR ratings were associated with a significantly greater decline in patient Elixhauser comorbidity scores compared with higher-rated hospitals (difference -0.48; P<0.0001).
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