New Report Examines Patient Outcomes for Coronary Bypass Surgery at Hospitals Statewide

A new report on coronary artery bypass graft surgery outcomes in hospitals statewide has made California the fourth state to publicly disclose hospitals' performance records on the procedure, the San Francisco Chronicle reports. Compiled by the Office of Statewide Health Planning and Development and the Pacific Business Group on Health, the study examined mortality rates from 30,800 coronary artery bypass graft procedures performed at 79 hospitals during 1997 and 1998. The hospitals, which participated on a voluntary basis, were responsible for approximately 70% of the procedures in the state during that period (Colliver, San Francisco Chronicle, 8/3). The report, titled "The California Report on Coronary Artery Bypass Graft Surgery: 1997-1998 Hospital Data," found that most of the hospitals in the study "performed as expected," while some "performed significantly better than expected" and four performed "worse than expected" (PBGH/OSHPD release, 8/2). The three top performing hospitals were Summit Medical Center in Oakland, Sutter Memorial in Sacramento and Hoag Memorial Hospital Presbyterian in Orange County (Lee, AP/Sacramento Bee, 8/3).

Dr. Robert Brook, director of the health science program at RAND and chair of the report's technical advisory committee, said that one "surprising result" of the study was the "lack of a strong correlation" between surgery outcomes and the volume of procedures performed at a given hospitals. The Chronicle reports that hospitals that perform more procedures "typically" have lower mortality rates (San Francisco Chronicle, 8/3). Dr. David Carlisle, director of OSHPD, said that the overall in-hospital death rate associated with bypass surgery is 2.6%. The study adjusted the data "for differences in the mix of patients treated by each institution" and took into account the pre-operative condition of patients so that hospitals "do not have an incentive to avoid treating sicker patients" (PBGH/OSHPD release, 8/2). A report showing 1999 hospital data on coronary heart procedures will be released later this year, and 2000 data will be available by the middle of next year (San Francisco Chronicle, 8/3).

Cheryl Damberg, a co-director of the study, said that the report will help "foster greater accountability among hospitals" because patients will be able to access "key data about hospital performance results." She added that before the report, patients had "little or no information to guide decisions on where to have surgery" (AP/Sacramento Bee, 8/3). But Damberg added that the report was only "the first round of results," and that consumers should not form opinions about hospitals "based on this one-time result" (PBGH/OSHPD release, 8/2). Brook said that techniques similar to those used in the coronary bypass report could be used to monitor hospital data on other procedures and conditions, such as pneumonia and stroke (San Francisco Chronicle, 8/3). To read the report, go to http://www.oshpd.cahwnet.gov//hpp/ccmrp/report.htm.