Public Outcomes Reporting Tied to Drop in Valve Replacements
Fewer aortic valve surgeries performed for people with endocarditis, regardless of injection drug use
MONDAY, Oct. 21, 2019 (HealthDay News) -- Initiating public reporting was associated with a significant decrease in valve surgery for all infective endocarditis (IE) cases, regardless of injection drug use (IDU) status, according to a study published Oct. 10 in Clinical Infectious Diseases.
Simeon D. Kimmel, M.D., from the Boston Medical Center, and colleagues used data from the National Inpatient Sample (January 2010 to September 2015) to identify individuals aged 18 to 65 years with a diagnosis code of endocarditis. IDU-IE was further identified using a validated combination of diagnostic codes.
The researchers identified 7,322 hospitalizations for IDU-IE and 23,997 for non-IDU-IE (representing 36,452 national IDU-IE admissions and 119,316 non-IDU admissions). After implementation of public outcomes reporting for aortic valve surgery in 2013, the odds of valve replacement decreased 4 percent per quarter (odds ratio [OR], 0.96), with no difference by IDU status. There was a 2 percent decrease in odds of inpatient death per quarter for both IDU-IE and non-IDU-IE following reporting (OR, 0.98).
"Our results have significant implications for policy-makers considering public reporting as a means to improve quality and clinicians caring for individuals with endocarditis," the authors write. "While public reporting may have improved the overall aortic valve surgery quality, the measures may have decreased access to valve surgery for IDU-IE and nonIDU-IE patients."