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Coronary Artery Bypass Graft (CABG)
 

Coronary Artery Bypass Graft (CABG)

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    Coronary Artery Bypass Graft (CABG) Coronary Artery Bypass Graft (CABG) Document Transcript

    • OREGON HOSPITAL QUALITY INDICATOR PROJECT, 2005 HEART BYPASS SURGERY (CABG) perfect. The adjusted death rate isWhat is a Coronary Artery presented in the displays that follow. TheBypass Graft?* average death rate for CABG in the UnitedCoronary artery bypass graft (CABG) States was 2.8% in 2003, the most recentsurgery creates new routes around a portion date for which data is available. In Oregon,of an artery that has been narrowed or the death rate was 3.3% in 2005. This reportblocked by plaque buildup (atherosclerosis). uses the statewide average as theThe blocked portion of the artery is reference rate.bypassed using a blood vessel taken from The Summary Tableelsewhere in the body (usually the chest orleg). Blood is redirected through the new The summary table tells you whichblood vessel, restoring blood flow to the differences in death rates are large enoughaffected portion of the heart muscle. to be considered “statistically significant,” orCoronary artery bypass surgery is a common outside the margin of error. Statisticaltreatment for coronary artery disease. See differences are based on the margin ofHealthwise for additional information on errors described below. With the stateCABG Surgery. average as the reference value: • If a hospital’s rate is significantly lower*Adapted with permission from Healthwise®Knowledgebase, © 1995-2005 Healthwise, than the state average, the summaryIncorporated, P.O. Box 1989, Boise, Idaho 83701. ALL table tells you it is “Better than average.”RIGHTS RESERVED • If a hospital’s rate is significantly higherWhat do these indicators than the state average, the summary table tells you it is “Worse than average.”mean? • If a hospital’s rate is statistically neitherVolume. The number of patients who had higher nor lower than the state averagea coronary artery bypass graft (CABG) is (within the margin of error), the summarydisplayed as the volume. CABG is highly table tells you it is “Average.”specialized, and staff at hospitals thatperform more of these surgeries may be Margin of Errormore familiar with possible complications Each hospital rate is displayed as a point onthat can occur. Therefore, performing more a line in the death rate graphs following theof these surgeries may lead to better volume graphs. These lines represent theoutcomes. Volume is not a direct measure amount of random variation or “noise” inof the quality of care, but is useful in the data. If the hospital line crosses thegauging how much experience a particular band representing the state average, thehospital has for this procedure. hospital rate is “within the margin of error”Research indicates that performing at least and therefore not statistically different than200 surgeries per year may lead to better the state average for this procedure.patient outcomes. In Oregon, eight hospitals A black line indicates that the hospital rateperformed 200 or more. is NOT statistically different from the state average. A blue line indicates that theDeath Rate. The CABG death rate is the hospital rate is statistically worse than thepercent of patients admitted for CABG who state average, and a green line indicatesdied in the hospital. However, some patients that the hospital rate is statistically betterare sicker or more difficult to treat, and than the state average. The margin of errorsome hospitals admit more of these is wider for hospitals with fewer heart bypasscomplex patients than others. Each patients.hospital’s death rate is adjusted to helpaccount for differences in these factors, butkeep in mind that the adjustment is notAugust 2006 Office for Oregon Health Policy and Research Page 1 of 4
    • Oregon Hospital Quality IndicatorsSUMMARY TABLE: HEART BYPASS (CABG) DEATH RATES, 2005 Hospital Post-Procedure Statewide post procedure death rate: 3.3% Death Rate Compared to State Average**State of Oregon State Average: 3.3%Good Samaritan Regional Medical Center (Corvallis) AverageLegacy Emanuel Hospital AverageLegacy Good Samaritan Hospital and Medical Center AverageOHSU Hospital AverageProvidence Portland Medical Center AverageProvidence St. Vincent Medical Center AverageRogue Valley Medical Center AverageSacred Heart Medical Center AverageSalem Hospital AverageSt. Charles Medical Center (Bend) AverageTuality Healthcare Average ** Too few cases: Statistical testing is not conducted when there are fewer than 30 cases. Hospitals with zero cases are not included. If the difference between the statewide death rate and a hospital’s death rate is large enough to be “statistically significant” or outside the “margin of error” (CI 95%), it is noted here: “Better than average” means the hospital death rate is statistically lower than the state average. “Average” means the hospital rate is not statistically different than the statewide average. “Worse than average” means the hospital death rate is statistically higher than the statewide rate.August 2006 Office for Oregon Health Policy and Research Page 2 of 4
    • Oregon Hospital Quality Indicators Coronary Artery Bypass Graft (CABG) Volume Oregon, 2005 0 200 400 600 800 Good Samaritan Regional Med Ctr (Corvallis) 232 Legacy Emanuel Hospital 80 Legacy Good Samaritan Hospital and Med Ctr 275 OHSU Hospital 61 Providence Portland Med Ctr 239 Providence St. Vincent Med Ctr 748 Rogue Valley Med Ctr 534 Sacred Heart Med Ctr 511 Salem Hospital 273 St. Charles Med Ctr (Bend) 245 Tuality Healthcare 48 Threshold Volume >=200Notes • Hospitals not shown performed fewer than 5 of these procedures in 2005. • Applies to adults 40 years of age and older. • Statewide Coronary Artery Bypass Graft (CABG) volume was 3,210 in 2005 • See Technical Documentation for more detail • Hospitals that submitted additional information about their volume are underlined; click on the hospital name to access their comments. • The Agency for Healthcare Research and Quality indicates that performing more than 200 cases per year may lead to better outcomes.August 2006 Office for Oregon Health Policy and Research Page 3 of 4
    • Oregon Hospital Quality Indicators Coronary Artery Bypass Graft (CABG) Death Rate Oregon, 2005 State Average = 3.3%Number of cases is in parentheses. Hospitals not shown had fewer than 30 cases in the reporting year.Horizontal lines represent the margin of error (based on 95% confidence intervals). A black line indicates the hospital rate is statistically the same as the state average. All Oregon hospitals are statistically the same as the state average for post-procedure deaths following a coronary artery bypass graft.Additional Notes • Number of CABG’s performed appear in parentheses. Hospitals not shown performed fewer than 30 of these procedures in 2005. • Rates have been adjusted for age, sex, and risk of death • Applies to adults 40 years and older. • See Technical Documentation for more detail • Lower rates may represent better quality.Hospital Comments • OHSU HospitalAugust 2006 Office for Oregon Health Policy and Research Page 4 of 4