New study names top 100 cardiac hospitals
What are they doing that you aren’t?
What makes cardiac care in some hospitals better than in others? That’s the question asked in a new study of the best-performing hospitals for cardiovascular services.
The study, conducted by Evanston, IL-based HCIA-Sachs, found significant differences in performance between the top 100 hospitals and their peers, with variations of as much as 11% to 22% in clinical outcomes for services in the areas of heart attack, angioplasty, and artery-related treatments and procedures.
The study also found large variations in costs, with the best hospitals spending nearly $700 less per case.
Another finding of the study was that patients receiving stent implants during angioplasty procedures were less likely to undergo a second angioplasty procedure during the study period, and the top hospitals all were more likely to use stents during angioplasty procedures.
Based on the study, HCIA-Sachs analysts determined that if hospitals included in the study performed at the level of the best 100 hospitals, the following would result:
1. Deaths from cardiovascular surgery would be drastically reduced. Mortality rates would decrease nearly 15% for both angioplasty and bypass procedures, while postoperative mortality rates would drop 18%.
2. The mortality rate for heart attack patients not requiring invasive procedures would drop by 9% for heart attack patients.
3. Patient infections after surgery would plummet 26%, while post-procedural hemorrhage would fall 21%.
4. Hospitals could cut cardiology costs by $250 million — an average of $415,000 per hospital.
5. Lengths of stay for cardiac patients would fall by an average of half a day.
The study focused on cardiovascular services in the areas of acute myocardial infarction (AMI), percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass graft (CABG) procedures.
The top performers included 26 teaching hospitals with cardiovascular residency programs, 45 teaching hospitals without cardiovascular residency programs, and 31 nonteaching hospitals.
The methodology used in calculating the performance measures for the top 100 hospitals is based on computerized review and analysis of 887,172 Medicare cardiovascular cases, using the following measures:
• risk-adjusted medical AMI patient mortality index;
• risk-adjusted surgical patient mortality index (includes PTCA, CABG, and postoperative mortality indices);
• risk-adjusted postoperative infection index [postoperative is defined by the presence of surgical discharge diagnosis-related groups (DRG)];
• risk-adjusted postoperative hemorrhage index (postoperative is defined by the presence of a surgical discharge DRG);
• percentage of CABG patients with internal mammary artery use;
• percentage of PTCA patients with CABG surgeries during the same admission;
• severity-adjusted average length of stay;
• wage and severity-adjusted average cost.
Next month, Healthcare Benchmarks will look more closely at some of the best performers, their cardiovascular programs, and the clinical and financial outcomes they achieved in order to merit inclusion in the top 100 hospitals.
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