Benchmarking
FAIR COMPETITION – A GREAT INCENTIVE!
Our focus lies on the quality of medical care and its continuous improvement. We provide all participating centers with comprehensive feedback including overviews on characteristics, treatment, complications, and long-term outcome of their patients compared to the other centers, thus inspiring them to enter into competition about quality.
From 2002 to 2005, the CYPHER registry included more than 12,000 patients. They all were implanted one specific DES (drug-eluting stent). In the investigated centers, the share of patients with STEMI (ST-elevation myocardial infarction) as a particularly serious disease ranged from 0 to 37%.
The complication rates at the centers (death or myocardial infarction within 6 months) ranged from 0 to 12%. Are these figures the result of more seriously diseased patients or simply based on variations in quality among the centers?
Statistics Ensure Fairness!
To be able to investigate the healthcare quality of each center in a fair manner, the probability for each of the 12,000 patients suffering from occurrence of an event within 6 months post stent implant was calculated using mathematical-statistical methods. Establishing “fair” healthcare quality comparison methods increases the acceptance of such comparisons in cardiology. For example, a 50 year old man with stable angina pectoris lacking additional risk factors has a 1% risk of death or myocardial infarction while an 80 year old woman with a previous myocardial infarction and cardiogenic shock has an almost 50% risk of death or myocardial infarction. These individual risks were then collected statistically for all patients of a center and given consideration. In the end, the SER (Standardized Event Ratio) represents an “adjusted“, transparent and comparable value. If the SER of a center is larger than 1 it means that the center’s healthcare quality is worse than the average, while an SER smaller than 1 reflects a good quality of care.