Is Zero the Ideal Death Rate?

Abstract

Massachusetts recently joined New York, New Jersey, and Pennsylvania in reporting death rates associated with cardiac surgery for individual surgeons — another wave in the tide of public reporting that is sweeping the country. Such reporting raises questions about distinguishing the goals that define one's work from the targets used to measure success. For hospitals and physicians, minimizing death and complications is an undisputed goal. But is zero the ideal target for measures of performance with respect to death and complications?In this era of public accountability, the answers to questions such as this turn out to be surprisingly complex. . . .