Hospitals, Surgeons Rated for Bypass Surgery in State Report
The Office of Statewide Health Planning and Development on Thursday posted a report on its Web site that rates surgeons and hospitals in California that performed heart bypass operations during 2003 and 2004, the Los Angeles Times reports.
The report used data on 40,377 coronary bypass procedures performed by 302 surgeons at 121 hospitals during the two-year span. The average mortality rate for the procedures was 3.08%, or about one in every 30 patients (Engel, Los Angeles Times, 7/13).
The study only included deaths within the first 30 days after surgery or until hospital discharge, whichever was longer (Dahlberg, Sacramento Bee, 7/13).
The rating system used a formula that adjusted for factors that can increase the risk of death, such as:
- Co-existing medical conditions; and
- Prior heart surgeries.
The agency in the past has published hospital mortality rates for bypass surgery, but this report is the first that rates individual surgeons. It is part of a broader effort to provide consumers information to make informed health care decisions, according to the Times (Los Angeles Times, 7/13).
David Carlisle, OSHPD director, said public reporting is important because it "provides a direct incentive for providers to focus on quality-of-care enhancement" (Russell et al., San Francisco Chronicle, 7/13).
Carlisle added that posting the results to the public will prompt hospitals and surgeons to examine their practices and look to improve their ratings (Los Angeles Times, 7/13).
The study was conducted following authorization by lawmakers in 2001.
The report ranked some highly regarded physicians as having higher-than-average mortality rates, a situation the doctors said could deter surgeons from accepting patients who are at higher risk for poor outcomes.
For example, Charles Hoopes, director of the heart and lung transplantation program at UC-San Francisco Medical Center, and Ismael Nuno, chief of cardiac surgery at Los Angeles County-USC Medical Center, received higher-than-average mortality ratings on the report.
Nuno said, "People are dying because of what the state of California is doing. Surgeons are walking away and saying, 'Tough, it's either my career or your death'" (San Francisco Chronicle, 7/13).
California is one of five states to report the mortality rates, and its average was highest among the states.
However, Carlisle said New York in 1989 became the first state to report such rates, and since then its rate has decreased (Los Angeles Times, 7/13).