The data used in the Cardiovascular Benchmarks for Success study are from Solucient’s hospital database. The hospital database contains more than 800 data elements for over 6,000 U.S. acute care and specialty hospitals. Virtually every general acute care hospital with 25 or more beds in service is included in the database, as well as all hospitals with bonds rated by Standard & Poor’s.

Solucient, as well as many others in the health care industry, has used these databases for many years and believes them to be accurate and reliable sources for the types of analyses performed in this study. Medicare inpatients usually represent about 55 percent of all patients experiencing acute myocardial infarction (AMI), 47 percent of all patients undergoing percutaneous transluminal coronary angioplasty (PTCA) and 51 percent of all patients undergoing coronary artery bypass graft (CABG) surgery. Furthermore, many previous academic and economic studies of health care in the United States have been based on the assumption that Medicare data are representative of the “all-payer” activity at hospitals.

THE COMPARISON GROUPS: Each hospital in the study was assigned to one of three peer groups according to its teaching and residency program status:

• Teaching hospitals with cardiovascular residency programs.
• Teaching hospitals without cardiovascular residency programs.
• Community hospitals

Within each of the three peer groups, hospitals were scored based on their performance in each of the measures relative to other hospitals in their group. First, each hospital was given a single score for each of the eight measures. These scores were then summed to arrive at a total score for each hospital within each of the three peer groups.

THE PERFORMANCE MEASURES: We compiled a group of eight measures of clinical quality practices and efficiency of operations that we believe constitutes the most reliable, scientific way possible to produce benchmarks for superior hospital performance. We also believe that using publicly available data for all hospitals supports this goal. The measures are listed below and described in detail in the study available for purchase:

The measures are:

1. Risk-adjusted medical (acute myocardial infarction) patient mortality index
2. Risk-adjusted CABG patient mortality index
3. Risk-adjusted PTCA patient mortality index
4. Risk-adjusted post-operative patient mortality index
5. Percentage of CABG patients with internal mammary artery use
6. Combined risk-adjusted post-operative infection index (post-operative is defined by the presence of a surgical discharge DRG), risk-adjusted post-operative hemorrhage index, and percentage of PTCA patients with CABG surgery during the same admission
7. Severity-adjusted average length of stay
8. Wage- and severity-adjusted average cost