title: The Society of Thoracic Surgeons voluntary public reporting initiative: the first 4 years.
abstract: OBJECTIVE
  To evaluate participant characteristics and outcomes during the first 4 years of the Society of Thoracic Surgeons (STS) public reporting program.
  
  
  BACKGROUND
  This is the first detailed analysis of a national, voluntary, cardiac surgery public reporting program using STS clinical registry data and National Quality Forum-endorsed performance measures.
  
  
  METHODS
  The distributions of risk-adjusted mortality rates, multidimensional composite performance scores, star ratings, and volumes for public reporting versus nonreporting sites were studied during 9 consecutive semiannual reporting periods (2010-2014).
  
  
  RESULTS
  Among 8929 unique observations (∼1000 STS participant centers, 9 reporting periods), 916 sites (10.3%) were classified low performing, 6801 (76.2%) were average, and 1212 (13.6%) were high performing. STS public reporting participation varied from 22.2% to 46.3% over the 9 reporting periods. Risk-adjusted, patient-level mortality rates for isolated coronary artery bypass grafting were consistently lower in public reporting versus nonreporting sites (P value range: <0.001-0.0077). Reporting centers had higher composite performance scores and star ratings (23.2% high performing and 4.5% low performing vs 7.6% high performing and 13.8% low performing for nonreporting sites). STS public reporting sites had higher mean annualized coronary artery bypass grafting volumes than nonreporting sites (169 vs 145, P < 0.0001); high-performing programs had higher mean coronary artery bypass grafting volumes (n = 241) than average (n = 139) or low-performing (n = 153) sites. Risk factor prevalence (except reoperation) and expected mortality rates were generally stable during the study period.
  
  
  CONCLUSIONS
  STS programs that voluntarily participate in public reporting have significantly higher volumes and performance. No evidence of risk aversion was found.
authors.affiliation: *Department of Surgery and Center for Quality and Safety, Massachusetts General Hospital, Boston, MA †Division of Cardiothoracic Surgery, University of Colorado, Aurora, CO ‡Department of Cardiac Surgery, University of Michigan Health System, Ann Arbor, MI §Division of Cardiothoracic Surgery, University of Florida, Gainesville, FL ¶Institute for Health Care Research and Improvement, Baylor Health Care System, Dallas, TX ∥Duke Clinical Research Institute, Durham, NC **Starr-Wood Cardiac Group, Portland, OR ††Vanderbilt University, Nashville, TN ‡‡Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA §§HCA North Texas Division, Dallas, TX ¶¶Society of Thoracic Surgeons, Chicago, IL ∥∥Johns Hopkins All Children's Heart Institute, All Children's Hospital, St. Petersburg, FL.
authors.forename: David M
authors.initials: DM
authors.lastname: Shahian
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Grover
authors.forename: Richard L
authors.initials: RL
authors.lastname: Prager
authors.forename: Fred H
authors.initials: FH
authors.lastname: Edwards
authors.forename: Giovanni
authors.initials: G
authors.lastname: Filardo
authors.forename: Sean M
authors.initials: SM
authors.lastname: OʼBrien
authors.forename: Xia
authors.initials: X
authors.lastname: He
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Furnary
authors.forename: J Scott
authors.initials: JS
authors.lastname: Rankin
authors.forename: Vinay
authors.initials: V
authors.lastname: Badhwar
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Cleveland
authors.forename: Frank L
authors.initials: FL
authors.lastname: Fazzalari
authors.forename: Mitchell J
authors.initials: MJ
authors.lastname: Magee
authors.forename: Jane
authors.initials: J
authors.lastname: Han
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Jacobs
mesh_terms: D022126:Access to Information; D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D033181:Information Dissemination; D008297:Male; D008875:Middle Aged; D011785:Quality Assurance, Health Care; D018570:Risk Assessment; D012955:Societies, Medical; D016019:Survival Analysis; D013903:Thoracic Surgery / Q000458:organization & administration*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States