Hospital transparency may be driving down stent use

Some U.S. states require hospitals to disclose the outcomes of stenting procedures, figuring that the transparency will allow patients to choose the best care. However, as a new study points out, patients in those states are less likely to get stents than those elsewhere.

In a study published in the Journal of the American Medical Association, researchers found that among 100,000 Medicare patients hospitalized for heart attacks in 2010, 38% underwent stenting procedures in states with mandatory reporting while 43% did so in states without, Reuters reports.

And the researchers aren't sure what's driving the trend, according to the news service. It might be that doctors are discouraged from performing the risky procedures, worried about the increased scrutiny of mandatory disclosure, or it could be that they have learned to better select which patients should receive stents, the researchers say.

Three states require outcome reporting--Massachusetts, Pennsylvania and New York--and while each experienced a drop in stenting rates after enacting the law, the trend doesn't appear to be tied to outcomes. Looking at Massachusetts, which mandated reporting in 2005, the researchers note that while the procedure became less common after mandating outcome reports, the number of patients dying within 30 days of stenting procedures remained the same, Reuters notes.

Lead researcher Karen Joynt tells the news service that the study can't conclusively explain the trend but will hopefully begin a dialog on the relationship between regulation and treatment. "There are a lot of states that are moving forward with public reporting, and I think transparency and accountability are not going away," she said. "Our hope is that this brings up a lot of questions."

- read the Reuters story