FOR IMMEDIATE RELEASE
Contact: Joe Martin, Communications Director
717-232-6787 or
Harrisburg, PA - March 10, 2004 - Inhospital patient mortality following coronary artery bypass graft (CABG) surgery in Pennsylvania dropped 16.6% between 2000 and 2002, according to a report released today by the Pennsylvania Health Care Cost Containment Council (PHC4). Mortality within 30 days of CABG surgery was also down, dropping 14.4% during the same period. Fewer patients were readmitted during 2002 than in 2000 - statewide rates within seven days after surgery decreased by 10.4%, and within 30 days, by 9.9%. Infection remained the number one cause for readmission. High volume surgeons generally continue to get better results than those doing fewer procedures.
"Dramatic improvements in quality can clearly be seen in mortality and readmissions, areas where public reporting has been heavily focused in recent years," stated Marc P. Volavka, PHC4's Executive Director. "Quality improvement efforts, however, could continue to focus on reducing infections, still the leading cause of readmissions."
Pennsylvania's Guide to Coronary Artery Bypass Graft Surgery 2002, PHC4's seventh report on heart bypass surgery, includes information on 16,435 CABG surgeries performed in Pennsylvania hospitals in 2002 at an average charge of over $80,000.
In the last five years, the number of CABG surgeries decreased by 12%, while angioplasty - another less invasive treatment for heart disease - increased by 21%. The average number of open-heart surgeries (including CABG) per hospital decreased 18.2%, from 499 in 2000 to 408 in 2002, while the average number per surgeon decreased 12.8%, from 149 cases in 2000 to 130 cases in 2002.
"It is particularly gratifying to see readmission rates following bypass surgery," noted Mr. Volavka. "Pennsylvania is the only state to release readmission data."
For each hospital and surgeon performing CABG surgery, the report provides information on the number of cases, inhospital mortality, 30-day mortality, 7-day and 30-day readmission rates, and post-surgical length of stay. Hospital charges are also reported. Charges have increased by 32% over the last five years, less than average charges overall, which increased 43% during the same period. Readmissions amounted to 11,654 hospital days and over $55 million in charges.
Surgeons who performed higher numbers of procedures (200-250 procedures) tended to have better results; i.e., lower patient mortality rates. Patients treated by surgeons who performed 200 to 250 surgeries were twice as likely to survive in the hospital as patients of surgeons with less than 100 procedures per year. In general, surgeons with higher numbers of surgeries had lower 30-day readmission rates than surgeons with lower volume, and patients treated by surgeons with higher volume had shorter post-surgical lengths of stay. The number of hospitals with open-heart surgery units has grown from 35 in 1990 (the period covered by the first PHC4 bypass report) to 62 in 2002.
"Surgeons performing higher numbers of procedures get better results," stated Mr. Volavka. "However, fewer bypass patients overall, combined with an increase in the number of open heart surgery centers, means that the average number of cases per surgeon and hospital is dropping."
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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