Does reporting of coronary artery bypass grafting from administrative databases accurately reflect actual clinical outcomes

摘要: Objectives Quality assessment of coronary artery bypass grafting has traditionally been performed with data from clinical databases. Administrative databases that rely primarily on information collected for billing purposes increasingly have used as tools public reporting outcomes quality. The correlation administrative quality not confirmed. Methods With a database, we analyzed the all patients who underwent surgery in 1 hospital between 1999 and 2001. This was before, during, after hospitalization by designated individuals involved patient's care then entered into an audited database (The Society Thoracic Surgeons National Cardiac Database). These were compared same cohort number procedures mortality rate reported federal government (Medical Provider Analysis Review), state (Texas Health Care Information Council), system (HCA, Inc, Casemix Database), internet Web site (healthgrades.com). Data basis population reported, definitions used, risk algorithms, case volumes. Results By using standard aggregating volumes inclusion criteria various sources data, found variances procedure mortality. Case overreported much 21% underreported up to 16% or more Medicare patients. Mortality exceeded 21%. Reasons included time period (calendar vs fiscal year), (all patients, aged ≥ 65 years), date patient record captured (date surgery, discharge), definition Different proprietary risk-adjusting algorithms magnified risk-adjusted exceeding 61%. Conclusions Substantial variability is seen sets end points makes it challenging nonclinician unfamiliar analysis make informed decision.