Variability in national AVR, CABG quality ratings confuses patients

Publicly posted hospital ratings could be confusing heart patients more than helping them, Reuters reported of a Journal of the American College of Surgeons study that found significant disparities between major rating systems in the U.S.

Ravi Ghanta, MD, and colleagues at Baylor College of Medicine compared the ratings of more than 600 highly-ranked hospitals, named the best in the country for heart surgery by the U.S. News & World Report, to those same hospitals’ ratings in other trusted databases, including Healthgrades, Society of Thoracic Surgeons (STS) and CMS. Their goal, Ghanta said, was to determine what kind of variability patients face when looking for a facility where they can safely undergo aortic valve replacement (AVR) or coronary artery bypass grafting (CABG).

“Public ratings of hospitals and surgeons are increasingly being utilized by patients to choose where to seek surgical care,” he told Reuters. “Ratings are also utilized by hospital organizations for marketing to patients and the community. Inconsistency in these ratings could confuse, rather than clarify, decision-making for patients.”

Of 602 hospitals deemed the best by the U.S. News & World Report for AVR and CABG between 2016 and 2017, the researchers found just two were also highly ranked by the STS, CMS and Healthgrades. Otherwise, rating distributions were highly variable—CABG ratings matched between 50 percent and 85 percent of the time, and AVR ratings matched 50 percent to 73 percent of the time.

Nicholas Osborne, a surgeon who wasn’t involved in the study, told Reuters hospital rating systems are “all over the place” and used for the wrong reasons, like marketing.

“We’re in real danger when we start replacing measures of quality with rating systems that may not measure or define what quality should be,” he said.

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