The Use of STS Public Reporting to Guide Referrals in Congenital Heart Surgery: Results of a Survey

Abstract

BackgroundThe Society of Thoracic Surgeons (STS) public reporting in congenital heart surgery has received considerable attention; however, it is unclear how pediatric cardiac providers use these data to guide surgical referrals. MethodsWe surveyed members of the American Academy of Pediatrics Section on Cardiology and Cardiac Surgery and PediHeartNet members regarding use of STS public reporting. ResultsThere were 155 respondents (90% cardiologist, 7% surgeons) from approximately 800 solicitations (∼19% response rate). While most (83%) felt that STS public reporting is important, 60% are unsure of its accuracy and only 37% find it useful in practice. Most (71%) believe STS public reporting leads to risk aversion. Overall, 92% answered that STS public reporting rarely or never overrides other factors determining referrals. Compared with smaller centers (<300 cases/year), providers in larger centers were more likely to report that STS public reporting data never overrides other factors determining referrals (54% vs 32%, P = .03). Providers using STS public reporting to guide referrals (14% overall) trust the system’s accuracy (P = .03) and believe it presents useful outcomes (P < .01). There was no correlation between use of STS public reporting to guide referrals and practice size, type, location, time in practice, surgical center affiliation, or center volume. ConclusionsProviders believe that public reporting of outcomes is important; however, most do not use the data to guide surgical referrals. Understanding these limitations of the current STS public reporting may enable change and increased usefulness for providers.