FOR IMMEDIATE RELEASE
Contact: Joe Martin, Communications Director
717-232-6787 or
Harrisburg, PA - May 08, 2002 - Inhospital patient mortality rates for coronary artery bypass graft surgery (often called heart bypass or CABG surgery) dropped 13% from 1995 to 2000, according to a new government report released today. The Pennsylvania Health Care Cost Containment Council (PHC4) study also noted that generally, surgeons performing higher numbers of procedures did the best job in keeping mortality rates low.
"The quality of care provided by Pennsylvania's cardiac surgeons and hospitals, already excellent, keeps getting better and better," stated Marc P. Volavka, Executive Director of PHC4. "By including four new quality measurements, this report goes much further than any other report available in helping to identify top notch cardiac care."
Pennsylvania's Guide to Coronary Artery Bypass Graft Surgery examines the results of more than 22,000 CABG surgeries performed in Pennsylvania in the year 2000. The last PHC4 CABG report covered 1994-95 data, focused mainly on in-hospital mortality and post-surgical length of stay, and was published in 1998. The new report includes those outcome measures plus several new ones: 30-day mortality, seven and 30-day readmission rates, and post-surgical length of stay for surgeons. Hospital charges are reported as well.
CABG surgery was performed in fifty-five Pennsylvania hospitals in 2000 - 14 more than in 1995 or a 34% increase. However, with only a slight increase in the number of CABG and other open -heart procedures since 1995 (27,446 in 2000 up from 27,264 in 1995), the average hospital volume decreased from 634 to 499 procedures during that same period. However, the average number of procedures per surgeon remained the same - 149 in both 1995 and 2000.
Although a hospital's volume of cases was not a significant factor in mortality, surgeon volume was an important predictor of whether a patient died in the hospital or within 30 days of the CABG surgery. The likelihood of in-hospital mortality was lower for patients treated by surgeons who performed over 115 open-heart procedures a year. 30-day mortality figures showed a similar pattern.
The number of operations performed by a surgeon was also an important predictor of post-surgical lengths of stay and hospital readmissions. Although the average post-surgical lengths of stay decreased by 12.3%, patients treated by surgeons with higher volumes generally had shorter lengths of stay. Furthermore, the likelihood of a patient being readmitted within 30 days decreased as the number of procedures performed by a surgeon increased, up to 190 procedures.
There was wide variation in readmission rates for both hospitals and surgeons. Seven-day readmission rates for hospitals ranged from 2.7% to 14.0%. For surgeons, the range was 1.2% to 18.2%. For 30-day readmission rates, the range for hospitals was 9.7% to 26.5% and the range for surgeons was 4.7% to 27.5%. However, patients were more likely to be readmitted to a hospital after CABG surgery if they were treated by surgeons affiliated with more than one hospital. Moreover, as the number of hospital affiliations rose, so did the likelihood of both 7-day and 30-day readmissions.
"The wide variation in readmissions among hospitals and surgeons as well as the effects of surgeons' multiple hospital affiliations suggest that there may be an uneven approach to patient care on some levels," noted Mr. Volavka. "While quality is high, these new outcome measures highlight opportunities to make further improvements."
The Pennsylvania Health Care Cost Containment Council is an independent state agency charged with collecting, analyzing and reporting information that can be used to make more informed decisions, thereby improving the quality and restraining the cost of health care in Pennsylvania. Copies of the report are free and can be ordered by calling PHC4 at 717-232-6787 or can be downloaded from PHC4's website at http://www.phc4.org.
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