Hospitals Performing More Heart Bypass Surgeries Have Fewer Fatalities, Survey Finds

Statewide fatality rates in hospitals from heart bypass surgery "vary considerably," but the best results appear in facilities that treat the most patients, according to a survey released yesterday by the state and the Pacific Business Group on Health, the San Francisco Chronicle reports. The survey, the "California Report on Coronary Artery Bypass Graft Surgery," compared fatality rates after bypass surgery among 70 of the 113 hospitals statewide that performed heart surgery in 1999 and during the three-year period between 1997 and 1999. The statewide average fatality rate during that period was 2.76%, according to the report. Survey results were adjusted depending on the severity of illness among patients treated at each hospital because a higher fatality rate among sicker patients "is no reflection of poor quality," the Chronicle reports (Russell, San Francisco Chronicle, 9/9).

The report found that hospitals that perform more bypass surgeries had better patient outcomes, while hospitals that perform fewer than 200 bypass surgeries had higher fatality rates, the San Diego Union-Tribune reports. In addition, 36 of the 70 participating hospitals and 35 of the 49 hospitals that did not participate in the survey performed fewer than 200 bypass surgeries -- fewer than half the 450 procedures necessary for a hospital to maintain proficiency, according to one national health care watchdog group, the Union-Tribune reports (Clark, San Diego Union-Tribune, 9/9). The Chronicle reports that most of the 49 hospitals that did not participate have smaller bypass surgery programs, and raw data -- which does not take into account the degree of patients' illnesses -- show that this group had a 3.34% fatality rate.

Proponents of the survey said it helps patients by pressuring hospitals to "follow protocols that work best," the Chronicle reports. However, some are "frustrated" by the delay in getting results to patients and criticized the survey for using outdated data. Although participation in the survey was voluntary, all hospitals with heart bypass surgery programs this year are required by a new state law to submit data for a similar report to be released in 2005 (San Francisco Chronicle, 9/9). The report is available online.