Pennsylvania'sFocus on Heart Attack— Grading the Scorecard

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Abstract
The era of “scorecard” cardiovascular medicine has arrived.1 New York was a pioneer in this field with its annual reports on mortality rates among patients undergoing coronary bypass surgery performed by various providers. In Pennsylvania, Colorado, and California, state agencies have compared hospital-specific mortality rates among patients with acute myocardial infarction. Regional coalitions of purchasers of health insurance have published, or are preparing to publish, similar reports in Cleveland, St. Louis, and Detroit. As managed-care organizations negotiate lower prices for medical services, report cards will become increasingly important to ensure that the quality of care does not suffer. These reports . . .