According to a new cohort study, medical centers that publicly report outcome data are more likely to receive defect-free care and have improved outcomes at discharge from the hospital. Michael T. Mullen, MD, MS, from the Lewis Katz School of Medicine, Philadelphia, and colleagues, reported these results in a manuscript published online Monday in the JAMA Network Open. Costs are lower, and transparency is higher when health care outcomes are visible to everyone. Accessible health care data allows the public to be in-the-know about health research, and health care professionals and policy makers can collaborate to make informed decisions about treatment guidelines. The Get With The Guidelines (GTWG)-Stroke improvement initiative was kicked off by the American Heart Association (AHA) over 20 years ago. Now, over 2,000 hospitals in the U.S. report roughly 80% of strokes to the registry. Those who participate in the program adhere to evidence-based stroke treatment and the treatment teams record clinical characteristics, treatment protocols and outcome data of the patients who are admitted to the hospital for stroke. Over time, more hospitals have joined the registry. The investigators in this trial examined the impacts of the GWTG-Stroke program to see if quality of care and clinical outcomes improved in cases where outcomes were publicly reported. Hospitals who publicly reported were compared with those who did not. The ability to walk independently upon discharge from the hospital was the primary outcome in this study. Secondary clinical outcomes included discharge to home, death in-hospital and a combined outcome of in-hospital death or discharge to hospice care. To measure quality, researchers summarized defect-free care: 7 ischemic stroke quality measures (intravenous thrombolysis for patients arriving by 3.5 hours and treated by 4.5 hours, early antithrombotic use within 48 hours of admission, venous thromboembolism prophylaxis, antithrombotics at hospital discharge, anticoagulation for atrial fibrillation or flutter, smoking cessation counseling and intensive statin therapy upon discharge, the authors noted). These were secondary outcomes. A total of 501,763 patients (mean age=69.8 years, 51.5% male; 69.3% White, 15.5% Black, 7.2% Asian; 7.6% Hispanic) were admitted across 2,423 hospitals for acute ischemic stroke. Of these hospitals, 65.3% participated in the public reporting system. Hospitals with a higher volume of patients and hospitals with higher performance ratings (GWTG-Stroke quality awards measurements from 2018) were both more likely to participate in the public reporting program. When analysis models made the appropriate adjustments for confounding variables, patients who were treated at hospitals participating in public reporting were associated with receiving defect-free care. Between-group absolute differences, however, remained small. Differences, again small, were also seen in independent walking upon hospital discharge (odds ratio [OR]=1.31, 95% confidence interval [CI]=1.27-1.35) and the composite secondary endpoint of in-hospital death or discharge to hospice care (OR=1.05, 95% CI=1.02-1.08). No differences were observed when it came to discharge to home or in-hospital deaths alone. Several limitations were noted by the authors of this manuscript, including the lack of ability to assess fora causal relationship between public reporting and outcomes. Other limitations included single-year data from 2021, relying upon hospitals to accurately report outcomes, missing data and lack of longer-term outcomes. Overall, investigators in this study saw some benefits in hospitals’ participation of the GWTG-stroke program. Hospitals with a higher volume and better performance were more likely to publicly report outcomes, and patients who were treated at centers that publicly report were more likely to have defect-free care. Source: Mullen MT, Zhao J, Jiang T, et al. Public reporting of quality and clinical outcomes in the Get With The Guidelines-Stroke Registry. JAMA Network Open. 2026 January 12 (Article in Press). Image Credit: Spiroview Inc. – stock.adobe.com