Posted on 10/31/2005 9:50:23 PM PST by neverdem
ASSOCIATED PRESS
ALBANY, N.Y. -- A report detailing the performance of 37 hospitals in New York shows mortality rates for heart surgeries declining, but critics say the information should be released faster and cover a broader range of procedures.
The report, which lets patients see which hospitals and surgeons have the best track records, shows that in 2003 the statewide mortality rate for patients undergoing coronary artery bypass surgery was 1.61 percent.
When the state first began tracking the surgeries in 1989, the mortality rate was 3.52 percent.
The improved mortality rate is being driven in part by the public scrutiny generated from the reports, said Blair Horner of the New York Public Interest Research Group.
"The fact that hospitals have to defend why they have the worst records forces them to examine the way they do business," he said.
Studies published in medical journals have shown that cardiac surgery report cards drive better care in New York, he said.
When the cardiac report cards were initiated under former Health Commissioner David Axelrod, the vision was to eventually expand the report cards to cover a variety of procedures, Horner said. That plan panned out under different commissioners, he said.
The Health Department did not immediately return calls for comment.
Matt Cox, spokesman for the Healthcare Association of New York State which represents more than 200 hospitals, says the data in the report is dated.
Since the program has been around for more than 15 years, Horner agreed that the department should be able to process the information faster.
"The Health Department isn't getting the information from the hospitals and out to the consumers fast enough," he said. "It's effectiveness is limited by the dated nature of the information."
In the past, Cox noted the lapse time was even longer.
"The more current the data, the better it is," he said.
Only one hospital, University Hospital of Brooklyn, had a significantly higher mortality rate than the state average for cardiac artery bypass graft surgery, according to the report.
The range of expected mortality rate for CABG is between .98 percent and 2.26 percent. University Hospital of Brooklyn had a mortality rate of 4.46 percent for the surgery, which is the most common procedure for coronary artery disease.
No hospitals had significantly lower mortality rates than the statewide average.
Mortality rates for valve or combined valve and CABG surgeries is also detailed in the report. Data is adjusted to take into account risk factors like smoking.
The report also lists the individual performances of surgeons who performed more than 200 procedures.
The data is posted on the Health Department's web site.
"Consumers shouldn't make their only decision based on the report, but it is an important factor - especially when you're looking at specific cardiologists, because there are differences there," Horner said.
On the Net:
Healthcare Association of New York State
New York Public Interest Group
If someone knows a cardiologist that does coronary artery bypass grafting(CABG) and surgically replaces defective heart valves, please let me know.
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"The improved mortality rate is being driven in part by the public scrutiny generated from the reports, said Blair Horner of the New York Public Interest Research Group.
"The fact that hospitals have to defend why they have the worst records forces them to examine the way they do business," he said."
Society only needs to get rid one or two by pass surgeons who shouldn't be operating on dead dogs or to close a heart surgery unit to improve our odds.
There is a grain of truth to what you have posted...at least when relating to 'improving odds'.
I would like to caution everyone that is hell bent on using simple statistics to evaluate medical institutions/providers capabilities...it is NOT that simple.
While it is easy to determine the number of 'deaths' etc., the denominator of the equation (the number of surgeries) amongst various surgical institutions is only equivalent IF the degree of illness of the patients is similiar...and that is rarely the case. So, comparing simple statistics among medical institutions/providers may or may not be relevant.
The public needs to be somewhat careful with what they wish for. In this case, if providers/institutions are harmed because of 'bad' statistics, I could easily see them start to be VERY selective with the patients they choose to treat...i.e., if someone is 'too sick' to attempt to help, they will may not receive surgery because it will cause them harm by degrading their statistical success numbers.
I'm not saying these statistics should not be obtained by some authority and utilized to attempt to weed out the bad apples...but widespread publication of these statistics to the general public, who by and large have no in depth knowledge of statistical analysis and may reach inappropriate conclusions, can have serious unintended consequences for the health care system.
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