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