Reported July 7,
2003
Ranking Death Rates by
Doctor
(Ivanhoe Newswire) -- If
death rates for specific
surgeons are made public, a new
study says they need to be very
specific. The report indicates
death rates would have to be
classified specifically by risk
level. The British health care
system plans to make mortality
rates for specific surgeons
public.
This study examined mortality
rates after coronary artery
bypass surgery. More than 8,500
patients were operated on by 23
surgeons during the study.
Overall mortality rate was 1.7
percent. The range of mortality
rates among doctors ranged from
none to 3.7 percent. The
researchers classified patients
into various risk groups and say
a large portion of the variation
among doctors is a result of the
risk level of the patients
undergoing the operation.
They write, “The small
proportion of high risk patients
is responsible for most of the
differences in predicted
mortality between surgeons.” The
researchers say it is misleading
to collect crude mortality
rates, without examining the
risk level. They also say it is
entirely possible to create a
national database, including
risk levels.
The authors of the study say
the current plan in the United
Kingdom is not in the best
interest of the patients. They
recommend a more specific system
be utilized. They fear cardiac
surgeons may turn down high-risk
patients if they are concerned
about the outcome “bringing down
their average.” It is their
recommendation that surgeons are
classified by the types of
patients on which they generally
operate.
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SOURCE: British Medical
Journal, 2003;327:13-17
