News Release | 1994-1995 | CABG

CABG 1994-1995 - News Release

FOR IMMEDIATE RELEASE

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

NEW OPEN-HEART SURGERY REPORT TO INCLUDE HEALTH PLAN DATA

Harrisburg, PA - May 7, 1998 - There is good news for those facing coronary artery bypass graft surgery in a new report released today by the Pennsylvania Health Care Cost Containment Council. According to Pennsylvania's Guide to Coronary Artery Bypass Graft Surgery, Pennsylvania's cardiac surgeons and hospitals do as good a job as expected, or better, in keeping bypass patients alive during and after the open-heart procedure. Related to that, overall patient mortality rates dropped 22% from 1991 to 1995, and hospital charges for the procedure decreased for the first time since the state began reporting the data in 1992.

The report also broke new ground by including, for the first time, mortality and length of stay statistics for bypass patients according to the health insurance plan they belonged to. Patients also fared well here, doing as well as could be expected within 33 of 34 health insurance plans studied by the Council. The statistics for health plans, hospitals and cardiac surgeons all take important patient risk factors into account before reporting the figures.

"With quality on the rise and costs on the decline, this report suggests that the Council's process of publicly reporting health care information is working," said Clifford L. Jones, Executive Director of the Council. "The report also sets the stage for more comprehensive reporting of health plan data in future reports, a top priority for the Council."

The report includes 1994-1995 risk-adjusted bypass patient mortality rates for Pennsylvania cardiac surgeons, hospitals, and for 34 health insurance plans operating in Pennsylvania. The health plans include licensed Health Maintenance Organizations (HMOs), Blue Cross plans, Commercial insurance companies, and the Medicare and Medicaid programs. The report also lists the average amount the hospitals charged for the procedure, risk-adjusted length of stay figures for hospitals and health plans, and information related to the volume of procedures performed by hospitals and surgeons.

Report Highlights

In 1994-95, the years covered by this study, 97% of the health plans, 91% of the hospitals, and 90% of the surgeons had risk-adjusted patient mortality rates that were well within what was expected or better after accounting for patient risk.
In-hospital mortality was 22% lower in 1995 than it was in 1991 (4.9% of the patients died in 1991 compared to 3.8% in 1995). At the same time, patient risk has remained constant and the total number of CABG surgeries has increased (up almost 25% since 1991).
Statewide, the average charge was 3.9% lower in 1994-95 than it was in 1993.
The patient's insurance plan was not a determinant of in-hospital mortality.
The surgeon's volume of open-heart surgery cases was an important determinant of in-hospital survival. Higher volume was associated with increased survival. The number of open-heart surgeries performed, on average, by a Pennsylvania cardiothoracic surgeon in 1994-95 was 127 per year.
Of the cases reported in the payor analysis, 89.2% were covered by fee-for-service plans (or some variation); only 10.8% were covered by HMO plans during 1994-95.
70% of the CABG patients were men; 30% were women.

In developing the statistics, the Council takes into account key health factors, otherwise known as risks, for each patient who underwent bypass surgery. The rating system then gives a certain weight to each risk factor, depending on its importance, based on the experiences of 38,577 patients who had bypass surgery in 1994 and 1995. For instance, a patient who had a previous bypass operation and who was in cardiogenic shock would have a greater risk of dying than a patient with no significant risk factors.

"Our system takes into account the fact that not all cardiac surgeons and CABG hospitals operate on the same kinds of patients, that some patients are sicker or at higher risk than others," said Marc P. Volavka, Director of Operations for the Council. "By adjusting for the risk of bypass patients, the system levels the playing field by giving "extra credit" to cardiac surgeons, hospitals and health plans who treat high risk patients. In this way, comparisons can be made in a more uniform and consistent manner."

Pennsylvania is one of only a handful of states that provide such information to the public and is the first to provide outcome-based information (mortality and length of stay) data about health plans.

Copies of the reports are free and can be ordered by calling or writing the Council. The report information is also posted on the Council's website at http://www.phc4.org.

The Pennsylvania Health Care Cost Containment Council is an independent state agency which provides the public with information that can be used to make more informed medical decisions and in so doing, improve the quality and restrain the cost of health care in Pennsylvania.