News Release | Coronary Artery Bypass Graft (CABG) Surgery 2004

Pennsylvania's Guide to Coronary Artery Bypass Graft (CABG) Surgery 2004 - News Release

FOR IMMEDIATE RELEASE

Contact: Joe Martin, Communications Director
717-232-6787 or

HEART BYPASS MORTALITY DROPS BELOW 2%; INFECTIONS REMAIN TOP READMISSION CAUSE

Harrisburg, PA - February 23, 2006 - In-hospital patient mortality following coronary artery bypass graft (CABG) surgery in Pennsylvania fell below 2 percent, dropping from 2.04 percent to 1.98 percent between 2003 and 2004, according to a report released today by the Pennsylvania Health Care Cost Containment Council (PHC4). That is the lowest mortality rate for the cardiac procedure in the 14 years since PHC4 began publicly reporting on this common form of open heart surgery. The report also noted that while readmission rates following CABG surgery fell during the same time period, infection remained the top reason for patient readmission within 7 and 30 days. On average, hospitals charged $99,483 for the procedure, while third-party commercial insurance payments (not including Medicare and Medicaid data which is not yet available) averaged $29,586.

"The drop in mortality is a tribute to Pennsylvania's top-notch surgeons and hospitals, as well as further evidence that public reporting works,” stated Marc P. Volavka, PHC4's Executive Director. "The next frontier should be to reduce readmissions associated with infections - particularly hospital-acquired infections."

Pennsylvania's Guide to Coronary Artery Bypass Graft Surgery 2004, PHC4's ninth report on heart bypass surgery, includes information on 13,359 CABG surgeries performed in Pennsylvania hospitals in 2004. For each hospital and surgeon performing CABG surgery, the report provides information on the number of cases, in-hospital mortality, 30-day mortality, 7-day and 30-day readmission rates, and post-surgical length of stay. Aggregate, statewide information about patients who contracted hospital-acquired infections during their hospitalization for CABG surgery is also included in the latest report.

When examining all open heart surgeries, the average number of cases per hospital decreased from 390 in 2003 to 376 in 2004 (a decline of 3.6 percent). The average number of open heart surgeries performed per surgeon has remained relatively constant since 2002 at about 130 cases.

Between 2003 and 2004, the 7-day and 30-day readmission rates dropped by 1.3 percent and 3.9 percent, respectively. Still, readmissions for infections within 30 days were associated with $19.4 million in hospital charges and more than 3,100 hospital days. Readmissions for infections within 7 days were associated with $10.3 million in hospital charges and more than 1,390 hospital days.

Of the 13,359 CABG patients in 2004, hospitals reported to PHC4 that 341 of them - or 2.6 percent - contracted one of the following types of hospital-acquired infections during their stay: a surgical site infection; indwelling catheter-associated urinary tract infection, ventilator-associated pneumonia or central line-associated bloodstream infection.

"Heart bypass patients with hospital-acquired infections were more likely to die, be readmitted and have longer lengths of stay than those patients without infections," said Mr. Volavka. "The average hospital charge for a CABG patient with a hospital-acquired infection was about three times higher than a CABG patient without an infection - with third-party insurance payments running nearly twice as high."

Specifically, a comparison of CABG patients with and without hospital-acquired infections revealed:

Of the CABG patients with a hospital-acquired infection (HAI), 12.6 percent died, compared to 1.7 percent of the CABG patients without an HAI.
The average length of stay for CABG patients with an HAI was 22.9 days, compared to 6.7 days for CABG patients without an HAI.
The 7-day readmission rate for CABG patients with an HAI was 13.2 percent, compared to 5.0 percent for CABG patients without an HAI.
The 30-day readmission rate for CABG patients with an HAI was 27.9 percent, compared to 12.9 percent for CABG patients without an HAI.
The average hospital charge for CABG patients with an HAI was $314,666, compared to $105,488 for CABG patients without an HAI.

Also new to this report, PHC4 has begun to collect and report commercial insurance payment data to further quantify the financial burden of hospital-acquired infections on CABG hospitalizations. The actual payment that hospitals received from commercial insurance companies for CABG patients with hospital-acquired infections averaged $51,337, compared to $29,281 for patients without a hospital-acquired infection.

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.