Association Between Online Physician Ratings and Cardiac Surgery Mortality.

Abstract

The ability of patients to accurately appraise healthcare quality is not well understood. Patient complaints and low satisfaction scores with physicians are associated with an increased risk of malpractice lawsuits and mortality, suggesting that patients can provide insight into healthcare quality.1–5 Physician rating websites have introduced a novel forum for patients to report their experiences. However, there are limited data on whether online ratings are associated with quality measures such as surgical outcomes. Previous studies investigating a link between patient satisfaction and healthcare outcomes are inconsistent.3,4,6–10 Thus, we investigated the association between online physician ratings and coronary artery bypass graft (CABG) mortality. We obtained surgeon-specific CABG outcomes from 2 publicly available sources: (1) the New York State Department of Health (https://www.health.data.ny.gov11) and (2) Pennsylvania’s Guide to Coronary Artery Bypass Graft Surgery (http://www.phc4.org/reports/cabg/1212). These databases have been well studied.13–16 We included 258 surgeons who met public reporting criteria for the most recent respective reporting periods (New York: n=135 and Pennsylvania: n=123). We focused on isolated CABGs as they are the most common cardiac procedure, and to minimize case-mix variation.11 ### New York This database provided the per-surgeon number of CABGs and mortalities, from discharged patients (December 2008–November 2011). Surgeons who performed at least 200 total cardiac procedures per time period and one or more operation per year of the time period were included.11 ### Pennsylvania This database provided the per-surgeon number of CABGs and mortalities, for discharged patients aged 30 and older (July 1, 2011–December 31, 2012). Surgeons who performed at least 30 CABGs annually were included.12 ### CABG Mortality Mortality for Pennsylvania was defined as death during the index hospitalization; for New York, mortality included death in hospital and within 30 days of discharge. Whereas New York provided both expected and adjusted …