National Survey of UK Consultant Surgeons' Opinions on Surgeon-Specific Mortality Data in Cardiothoracic Surgery

Autor: David P. Taggart, Kamran Baig, Thanos Athanasiou, Ara W. Darzi, Christopher Pettengell, Rakesh Uppal, Stephen Westaby, Omar A. Jarral
Rok vydání: 2016
Předmět:
medicine.medical_specialty
demography
Health Knowledge
Attitudes
Practice
Operations research
quality assessment
Attitude of Health Personnel
Information Dissemination
030204 cardiovascular system & hematology
Public opinion
Logistic regression
consultants
1102 Cardiovascular Medicine And Haematology
Risk Assessment
Grounded theory
outcomes research
Access to Information
03 medical and health sciences
0302 clinical medicine
Risk Factors
Surveys and Questionnaires
medicine
Humans
030212 general & internal medicine
Hospital Mortality
Cardiac Surgical Procedures
Policy Making
Referral and Consultation
Quality Indicators
Health Care
Response rate (survey)
Surgeons
Chi-Square Distribution
business.industry
Process Assessment
Health Care
Thoracic Surgical Procedures
Quality Improvement
United Kingdom
Data Accuracy
Logistic Models
Treatment Outcome
Cardiovascular System & Hematology
1117 Public Health And Health Services
Cardiothoracic surgery
Family medicine
Public Opinion
Outcomes research
Cardiology and Cardiovascular Medicine
Risk assessment
business
Zdroj: Circulation. Cardiovascular quality and outcomes. 9(4)
ISSN: 1941-7705
Popis: Background— In the United Kingdom, cardiothoracic surgeons have led the outcome reporting revolution seen over the last 20 years. The objective of this survey was to assess cardiothoracic surgeons’ opinions on the topic, with the aim of guiding future debate and policy making for all subspecialties. Methods and Results— A questionnaire was developed using interviews with experts in the field. In January 2015, the survey was sent out to all consultant cardiothoracic surgeons in the United Kingdom (n=361). Logistic regression, bivariate correlation, and the χ 2 test were used to assess whether there was a relationship between answers and demographic variables. Free-text responses were analyzed using the grounded theory approach. The response rate was 73% (n=264). The majority of respondents (58.1% oppose, 34.1% favor, and 7.8% neither) oppose the public release of surgeon-specific mortality data and associate it with several adverse consequences. These include risk-averse behavior, gaming of data, and misinterpretation of data by the public. Despite this, the majority overwhelmingly supports publication of team-based measures of outcome. The free-text responses suggest that this is because most believe that quality of care is multifactorial and not represented by an individual’s mortality rate. Conclusions— There is evident opposition to surgeon-specific mortality data among UK cardiothoracic surgeons who associate this with several unintended consequences. Policy makers should refine their strategy behind publication of surgeon-specific mortality data and possibly consider shift toward team-based results for which there will be the required support. Stakeholder feedback and inclusive strategy should be completed before introducing major initiatives to avoid unforeseen consequences and disagreements.
Databáze: OpenAIRE
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