Hannan E L, Stone C C, Biddle T L, DeBuono B A
Department of Health Policy and Management, School of Public Health, State University of New York at Albany, USA.
Am Heart J. 1997 Jul;134(1):55-61. doi: 10.1016/s0002-8703(97)70106-6.
Since 1990, risk-adjusted outcomes for patients undergoing coronary artery bypass graft surgery in New York state have been released to the public. The purpose of this study was to assess the extent to which referring cardiologists share these data with patients and use these data to make referrals.
A survey questionnaire was sent to all cardiologists in New York in the New York State Chapter of the American College of Cardiology.
Four hundred fifty cardiologists responded to the survey. Most (94%) found the report "easy to read." A majority (67%) found the report to be "very accurate" or "somewhat accurate" in capturing differences in the performance of cardiac surgeons, whereas 33% found it to be "not at all accurate." Twenty-two percent reported that they "routinely discuss the reports with their patients," and 38% responded that the information has affected their referrals to surgeons "very much" or "somewhat."
A majority of cardiologists has not generally changed their well-established referral patterns as a result of the New York coronary artery bypass graft surgery reports. However, there has been a modest impact on referrals resulting from the distribution of these reports. The findings also suggest that increased dialogue between clinicians and policy makers regarding the format and structure of public releases would be a valuable undertaking.
自1990年起，纽约州接受冠状动脉搭桥手术患者的风险调整后结果已向公众公布。本研究的目的是评估转诊心脏病专家与患者分享这些数据以及利用这些数据进行转诊的程度。
向美国心脏病学会纽约州分会的所有纽约心脏病专家发送了一份调查问卷。
450名心脏病专家回复了调查。大多数（94%）认为该报告“易于阅读”。多数（67%）认为该报告在反映心脏外科医生手术表现差异方面“非常准确”或“较为准确”，而33%认为“完全不准确”。22%报告称他们“经常与患者讨论这些报告”，38%回应称这些信息对他们转诊给外科医生“影响很大”或“有一定影响”。
大多数心脏病专家总体上并未因纽约冠状动脉搭桥手术报告而改变其既定的转诊模式。然而，这些报告的发布对转诊产生了一定影响。研究结果还表明，临床医生与政策制定者就公开报告的形式和结构加强对话将是一项有价值的工作。
