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To the Editor: The survey results reported by Drs Schneider and Epstein¹ pointed to a lack of use by individual consumers of the PennsylvaniaConsumer Guide to Coronary Artery Bypass Graft Surgery. However, the primary goals of the Pennsylvania Health Care Cost Containment Council are cost containment and quality improvement. While consumer empowerment is one way to achieve that goal, it is not the only way. Empowering large-group purchasers is another, and that is occurring in Pennsylvania.² Futhermore, there is evidence that the data have a significant impact on institutional decision making in hospitals.³ A 22% decline in mortality rates for Pennsylvanians receiving bypass procedures since 1991 suggests that the process of public reporting is working.⁴

It is worth noting that a front page Pittsburgh Post-Gazette article⁵ about the Harvard survey produced nearly 400 consumer requests for the bypass report. In addition, with the growing popularity of rapid and . . . [Full Text of this Article]

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Use of Public Performance Reports: A Survey of Patients Undergoing Cardiac Surgery
Eric C. Schneider and Arnold M. Epstein
JAMA. 1998;279(20):1638-1642.
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