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Relative Risk

Relative Risk

Relative risk (RR) is a statistical measure commonly used in epidemiology to compare the likelihood of a particular event occurring between two groups. This metric is important for evaluating the relationship between exposure to a specific risk factor and the probability of a particular outcome. It plays a crucial role in medical research, public health studies, and risk assessment. Relative risk quantifies how much more (or less) likely an event is to occur in an exposed group compared to an...

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Risk Aversion in Cardiac Surgery: 15-Year Trends in a Statewide Analysis.

Robert B Hawkins¹, J Hunter Mehaffey¹, William Z Chancellor²

¹Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville, Virginia; Center for Health Policy, University of Virginia, Charlottesville, Virginia.

The Annals of Thoracic Surgery

|September 27, 2019

Summary

This summary is machine-generated.

Hospitals are increasingly avoiding high-risk cardiac surgeries due to public reporting. Non-risk-averse hospitals demonstrate better outcomes for these complex cases, highlighting the need for transparent reporting to ensure patient access.

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Area of Science:

Cardiac Surgery Outcomes
Healthcare Quality Measurement
Hospital Risk Management

Background:

Public reporting initiatives may incentivize hospitals to avoid complex procedures.
This study investigates whether hospitals are becoming risk-averse in cardiac surgery.
The association between hospital risk aversion, patient outcomes, and quality metrics is examined.

Purpose of the Study:

To test the hypothesis that hospitals are avoiding high-risk cardiac operations.
To evaluate the link between hospital risk-averse practices and patient outcomes.
To assess the relationship with publicly reported quality measures.

Main Methods:

Analysis of 78,417 cardiac surgery cases (2002-2016) from a regional consortium.
Paired clinical data with public reimbursement and quality data.
Defined high-risk surgery (predicted mortality ≥5%) and hospital risk aversion (decreased high-risk volume/proportion).

Main Results:

39% of hospitals exhibited significant risk aversion, with a 59% decrease in high-risk volume versus 16% in non-risk-averse hospitals.
Non-risk-averse hospitals had better-than-expected mortality rates (0.88) compared to risk-averse hospitals (0.97).
No significant differences in reported ratings or financial incentives were observed between hospital groups.

Conclusions:

Non-risk-averse hospitals are high-performing, especially in high-risk cardiac surgery.
Care for high-risk patients is concentrated in these non-risk-averse institutions, influenced by transfer patterns.
Transparency in reporting is crucial for maintaining access to care for high-risk cardiac surgery patients.