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Editorials

Publicly Reporting Implantable Cardioverter Defibrillator Outcomes

Grading the Report Card

Stephen C. Hammill, MD and Jeptha Curtis, MD

From the Mayo Clinic (S.C.H.), Rochester, Minn; and Yale University (J.C.), New Haven, Conn.

Correspondence to Stephen C. Hammill, MD, Mayo Clinic, Rochester, MN 55905. E-mail hammill.stephen@mayo.edu

Key Words: Editorials • registries • implantable defibrillator

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The past decade has seen a dramatic increase in efforts by both payors and governmental agencies to measure and publicly report patient outcomes to ensure that patients receive appropriate, high-quality care. As a result, terms such as outcomes, quality, report cards, and benchmarking have entered the lexicon of clinical medicine, and both physicians and hospitals are increasingly being held accountable for the outcomes of their patients. This movement shows no sign of slowing down. In May 2008, the Centers for Medicare and Medicaid Services proposed increasing the total number of inpatient hospital measures from 40 to 73,¹ and numerous physician measures are in various phases of development. In the current environment, it is likely that implantable cardioverter defibrillators (ICDs), which reduce the risk of sudden cardiac death,² will soon emerge as a high-priority target for the development of performance measures, given that the procedure is expensive, performed on severely ill patients, and associated with significant risk of complications.

Article see p 240

Accordingly, the findings published by Al-Khatib et al³ in this issue of Circulation: Arrhythmia and Electrophysiology warrant consideration in the context of current efforts to publicly report patient outcomes using Medicare claims data. In this excellent article, the authors used data from Centers for Medicare and Medicaid Services standard analytic files to determine the 90-day postprocedure complication rates and 1-year mortality rates of 8581 Medicare beneficiaries who had an ICD implanted by one of 1959 implanting physicians. The authors note that the complication rate declined from 18.8% in . . . [Full Text of this Article]

Related Article

Patient and Implanting Physician Factors Associated With Mortality and Complications After Implantable Cardioverter-Defibrillator Implantation, 2002–2005

Sana M. Al-Khatib, Melissa A. Greiner, Eric D. Peterson, Adrian F. Hernandez, Kevin A. Schulman, and Lesley H. Curtis
Circ Arrhythm Electrophysiol 2008 1: 240-249. [Abstract] [Full Text] [PDF]