Baltimore, MD, May 30, 2000 — The HCIA-Sachs Institute Inc. today released the results of its year 2000 study identifying the nation’s top cardiovascular hospitals. The study, 100 Top Hospitals™: Cardiovascular Benchmarks for Success, names the best-performing hospitals for cardiovascular services.

The study found significant differences in performance between the top hospitals and their peers, with variations of as much as 11 to 22 percent in clinical outcomes for services in the areas of heart attack, angioplasty and artery-related treatments and procedures. The study also found large variations in costs: on average, top hospitals operate at nearly $700 less per case.

In a secondary finding, the study found that patients receiving stent implants during angioplasty procedures were less likely to undergo a second angioplasty procedure during the study period. 100 Top Cardiovascular Hospitals™ were more likely to use stents during angioplasty procedures.

Cardiovascular disease is the leading cause of death among Americans and accounts for nearly 300,000 Medicare hospitalizations each year. Approximately fifteen percent of what patients spend on hospital care is spent on cardiology, which makes the results of studies such as the 100 Top Cardiovascular Hospitals™ vital to hospital administrators, physicians, insurers and ultimately patients.

"The aim of the 100 Top Hospitals™: Cardiovascular Benchmarks for Success study is to guide improvement for the care of all cardiovascular patients," said Jean Chenoweth, executive director of the HCIA-Sachs Institute. "It can also help hospitals improve performance by providing cardiovascular benchmarks for comparative purposes."

Based on the study, HCIA-Sachs analysts determined that if hospitals included in the study performed at the level of the 100 Top Cardiovascular Hospitals™, the following would result:

• Deaths from cardiovascular surgery would be drastically reduced. Mortality rates would decrease nearly 15 percent for both angioplasty and bypass procedures, while post-operative mortality rates would drop 18 percent.
• The mortality rate for heart attack patients not requiring invasive procedures would drop by 9 percent for heart attack patients.
• Patient infections after surgery would plummet 26 percent, while post-procedural hemorrhage would fall 21 percent.
• Hospitals could cut cardiology costs by $250 million—an average of $415,000 per hospital.
• Lengths of stay for cardiac patients would fall by an average of half a day.

The study focused on cardiovascular services in the areas of acute myocardial infarction (AMI), percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass graft (CABG) procedures. The winners of the award included 26 teaching hospitals with cardiovascular residency programs, 45 teaching hospitals without cardiovascular residency programs, and 31 non-teaching hospitals. The stratification was chosen to maintain consistency with the representation of hospitals in each group, both throughout the country and in the 100 Top Cardiovascular Hospitals™ study group.

The methodology used in calculating the performance measures for the 100 Top Hospitals™: Cardiovascular Benchmarks for Success is based on computerized review and analysis of 887,172 Medicare cardiovascular cases, using the following measures:

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

A list of the 100 Top Hospitals™: Cardiovascular Benchmarks for Success study and a summary of the report are available via the Internet at http://www.100TopHospitals.com. Copies of the study can be purchased by calling HCIA-Sachs Institute Publications at (800) 568-3282.

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