Cardiovascular Benchmarks for Success:
   Introduction
   Methodology
   Findings
   Winners

Methodology

Throughout the life of the 100 Top Hospitals program, Solucient has worked to ensure that the measures and methodology we use are fair, consistent, and telling. We continually test the validity of our performance measures and the data sources. We also work to identify trends within the benchmark hospitals to determine what makes these hospitals different, and what enables them to consistently raise the bar for performance. A summary of the Methodology is presented here. For full details, you may purchase an abstract of the study.

THE DATA: The data used in the 100 Top Hospitals: Cardiovascular Benchmarks for Success study come from Solucient’s hospital database and the publicly available Medicare Provider Analysis and Review (MedPAR) data set. Data from the hospital database are used in calculating all the financial measures for this study. The data sets we use for the 100 Top Hospitals studies represent more than 6,000 U.S. hospitals and more than 12 million patient discharges. This year's study includes 2003 and 2004 data.

THE PATIENT GROUPS: The Solucient 100 Top Hospitals specialty benchmark studies focus on general and applicable specialty, short-term, acute care, non-federal U.S. hospitals. In this study, we focused on hospitals that treat a broad spectrum of cardiology patients, including those undergoing:

1. acute myocardial infarction (AMI)
2. congestive heart failure (CHF)
3. percutaneous coronary intervention (PCI)
4. coronary artery bypass graft (CABG)

THE COMPARISON GROUPS: Teaching and residency program status have a profound effect on the types of patients a hospital treats and the scope of services it provides. When analyzing the performance of an individual hospital, it is crucial to evaluate it against other similar hospitals. To address this, we assigned each hospital 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

THE PERFORMANCE MEASURES AND SCORING: We compiled a group of seven areas 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:

1. Procedure Volume Threshold
2. Risk-Adjusted Medical Mortality (includes risk-adjusted AMI patient mortality index and risk-adjusted CHF patient mortality index)
3. Risk-Adjusted Surgical Mortality (includes risk-adjusted CABG patient mortality index and risk-adjusted PCI patient mortality index)
4. Risk-Adjusted Complications Index (includes post-operative hemorrhages and post operative infections)
5. Percentage of CABG Patients with Internal Mammary Artery Use
6. Severity-Adjusted Average Length of Stay
7. Wage- and Severity-Adjusted Average Cost

Within each of the three peer groups, we scored hospitals based on their performance on each of the measures relative to other hospitals in their group.

For full details, the 2005 100 Top Hospitals: Cardiovascular Benchmarks for Success study abstract is now available!

Click here for more information or to order.

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