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The Impact of Public Reporting on Procedural Outcomes Following Congenital Heart Surgery

Award Number: K23HL153895
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 01/28/2022
PERIOD OF PERFORMANCE END DATE: 12/31/2025

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The Impact of Public Reporting on Procedural Outcomes Following Congenital Heart Surgery - PROJECT SUMMARY/ABSTRACT Natalie Jayaram, MD MSB is an Assistant Professor of Pediatrics at the University of Missouri-Kansas City and a faculty member in the Department of Pediatrics and Division of Cardiology at Children’s Mercy Hospital in Kansas City, Missouri. As a pediatric cardiologist and health services researcher, her long-term career goals are to improve the care of pediatric patients with congenital heart disease (CHD) by contributing to the science of quality assessment, by examining the effectiveness of policy-based initiatives on care, and by partnering directly with patients to facilitate changes in care. The goal of the current project is to study public reporting for congenital heart surgery (CHS). Public reporting is designed to provide healthcare consumers with outcome data for a given provider or institution. Proponents of public reporting advocate for transparent disclosure of health outcomes data and contend that public reporting results in improved outcomes.1-4 Critics of public reporting cite evidence that public reporting may not substantially improve outcomes and could result in unintended consequences, including risk avoidance practices.5-14 Formal study regarding the impact of public reporting on outcomes for CHS has never been performed. The highly specialized nature of CHD care, with relatively less local or regional competition compared to more prevalent conditions (e.g. adult cardiovascular disease) but with patients willing to travel to seek the ‘best’ care,15 suggest that public reporting for CHS warrants independent investigation. The primary aims of the proposed project are: 1) to evaluate whether, as an unintended consequence of public reporting, there is a shift in patient case mix, suggesting that centers could be avoiding surgical intervention in patients at highest risk for poor outcome 2) to evaluate the association between implementation of public reporting for CHS and surgical outcomes, and 3) to better understand the type and format of data that CHD patients and families would find most meaningful to help them make informed decisions regarding care. Study aims 1 and 2 of the project propose obtaining data from the State Inpatient Database in order to study the association between public reporting, institutional case mix, and surgical outcomes at centers throughout the US performing CHS. Study Aim 3 proposes focus groups involving CHD patients and caregivers to gain an improved understanding of their preferences with regards to public reporting. Together with her mentorship team, Dr. Jayaram has worked to create a career development plan that will provide her with additional training, education, and experience in the areas of advanced statistical methodology, experience in working with administrative data, and formal training in qualitative research and patient engagement. Overall, the skills learned from this project and educational plan coupled with an outstanding mentorship team will allow Dr. Jayaram to achieve her ultimate goal of becoming an independent investigator and leader in the field of pediatric cardiovascular outcomes research.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $166,869 )
2025	2025	CHILDRENS MERCY HOSPITAL	2401 GILLHAM RD	KANSAS CITY	MO	64108	JACKSON	USA	Cardiovascular Diseases Research	000	4	12/9/2024	NON-COMPETING CONTINUATION	$166,869
														Subtotal = $166,869

Issue Date FY: 2024 ( Subtotal = $167,863 )
2024	2024	CHILDRENS MERCY HOSPITAL	2401 GILLHAM RD	KANSAS CITY	MO	64108	JACKSON	USA	Cardiovascular Diseases Research	000	3	12/15/2023	NON-COMPETING CONTINUATION	$167,863
														Subtotal = $167,863

Issue Date FY: 2023 ( Subtotal = $167,331 )
2023	2023	CHILDREN'S MERCY HOSPITAL, THE	2401 GILLHAM RD	KANSAS CITY	MO	64108	JACKSON	USA	Cardiovascular Diseases Research	000	2	12/13/2022	NON-COMPETING CONTINUATION	$167,331
2023	2023	CHILDRENS MERCY HOSPITAL	2401 GILLHAM RD	KANSAS CITY	MO	64108	JACKSON	USA	Cardiovascular Diseases Research	001	2	8/31/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $167,331

Issue Date FY: 2022 ( Subtotal = $171,535 )
2022	2022	CHILDREN'S MERCY HOSPITAL, THE	2401 GILLHAM RD	KANSAS CITY	MO	64108	JACKSON	USA	Cardiovascular Diseases Research	000	1	1/28/2022	NEW	$171,535
2022	2022	CHILDREN'S MERCY HOSPITAL, THE	2401 GILLHAM RD	KANSAS CITY	MO	64108	JACKSON	USA	Cardiovascular Diseases Research	001	1	7/21/2022	NEW	$0
														Subtotal = $171,535

Grand Total All Awards = $673,598

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The Impact of Public Reporting on Procedural Outcomes Following Congenital Heart Surgery

Award Number: K23HL153895

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 01/28/2022

PERIOD OF PERFORMANCE END DATE: 12/31/2025

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