• David Dunt, Khic-Houy Prang, Hana Sabanovic, and Margaret Kelaher.
• Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Vic., Australia.
• Med Care. 2018 Nov 1; 56 (11): 956-966.

ObjectivePublic performance reporting (PPR) of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) outcomes aim to improve the quality of care in hospitals, surgeons and to inform consumer choice. Past CABG and PCI studies have showed mixed effects of PPR on quality and selection. The aim of this study was to undertake a systematic review and meta-analysis of the impact of PPR on market share, mortality, and patient mix outcomes associated with CABG and PCI.MethodsSix online databases and 8 previous reviews were searched for the period 2000-2016. Data extraction, quality assessment, systematic critical synthesis, and meta-analysis (where possible) were carried out on included studies.ResultsIn total, 22 relevant articles covering mortality (n=19), patient mix (n=14), and market share (n=6) outcomes were identified. Meta-analyses showed that PPR led to a near but not significant reduction in short-term mortality for both CABG and PCI. PPR on CABG showed a positive effect on market share for hospitals (3 of 6 studies) and low-performing surgeons (2 of 2 studies). Five of 6 PCI studies found that high-risk patients were less likely to be treated in States with PPR.ConclusionsThere is some evidence that PPR reduces mortality rates in CABG/PCI-treated patients. The significance of there being no strong evidence, in the period 2000-2016, should be considered. There is need for both further development of PPR practice and further research into the intended and unintended consequences of PPR.

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