: Publicly reported quality information is intended to improve healthcare. An unplanned response to report cards is that physicians avoid high-risk patients to improve their ratings. The purpose of this research is to investigate the impact of CABG report cards on physicians' selections of patients for surgery. The central hypothesis is that physicians select patients using observable characteristics, such as race, which are perceived as signals for unobservable health characteristics. This selection will cause a differential impact of CABG report cards on patients who are perceived as being the highest risk.
The specific aims are: 1) to test whether observable patient characteristics such as race have an impact on the incidence of CABG surgery after release of CABG report cards; 2) to determine surgeon characteristics that are associated with patient avoidance; and 3) to test whether CABG report cards have a differential impact on patient outcomes by observable patient characteristics. Using administrative data from states that release CABG report cards compared to a national sample of hospital discharges, the candidate will compare the provision of CABG care before and after the release of CABG report cards to determine the impact of CABG report cards on patients with heart disease. ? ? ?
