Solucient Study Shows Wide Performance Gaps Among High-Volume Hospitals Treating Heart Disease

• Mortality rates 27 percent lower at top-performing hospital
• Solucient 100 Top Cardiovascular Hospitals and benchmarks identified for 2001

(Evanston, IL, -- July 2, 2001) -- A study released today by Solucient finds that even among hospitals that perform high volumes of heart disease procedures – such as bypass grafts and angioplasty -- wide gaps in risk-adjusted mortality and complication rates exist. The best-performing cardiovascular hospitals, which are named in the study, have mortality and complication rates as much as 27 percent lower than non-winning hospitals.

Moreover, if peer hospitals in the study achieved the success levels of the top hospitals, each hospital would cut the average cost per cardiology case by more than $2,000 – a savings of $1.35 million annually among Medicare patients alone. Deaths from the procedures studied would drop 23 percent and post-operative mortality rates would drop 30 percent in the peer hospitals.

“Volume has been shown to be a critical factor in determining which hospitals have better outcomes for certain procedures,” explains Jean Chenoweth, executive director of the Solucient Institute. “But this analysis, which was restricted to hospitals with high volumes of cardiac patients, clearly indicates that volume alone does not ensure the best results, at least in terms of mortality, hemorrhage and infection. This study is a call for action -- the industry needs to provide consumers with a broader group of measures for describing best practices in all hospitals.”

The annual study, “Solucient100 Top HospitalsTM: Cardiovascular Benchmarks for Success,” names organizations that are among the best-performing hospitals for treating heart attacks and cardiovascular disease. The study also analyzes specific procedures and conditions. Among the significant differences found between the top hospitals and their non-winning peers:

• When performing percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass surgery (CABG), the rate of post-operative infection is an average 21 percent lower among all top hospitals, and an average 34 percent lower at top community hospitals.
• Heart attack patients have a 7 percent lower risk-adjusted mortality rate at top-performing hospitals – among community hospitals, the rate is 11 percent lower.
• In a secondary finding, the study shows that the use of stent implants during PTCA increased from 63 percent in last year’s study to 79 percent this year. Stents, scaffold-like devices that shore-up the arterial wall, are clearly used as a widely accepted practice in top performing and non-winning hospitals alike.

Cardiovascular disease is the leading cause of death in the U.S., killing nearly 1 million Americans annually, according to the American Heart Association. It accounts for at least 300,000 Medicare hospitalizations annually and an estimated $298 billion in direct and indirect costs this year.

"As the Institute of Medicine, the Leapfrog Group and other health care interests clamor for improved quality of care, the Solucient100 Top Hospitals: Cardiovascular Benchmarks for Success study provides a series of benchmarks to measure gross clinical performance and help hospitals identify opportunities for improvement in cardiovascular services,” Chenoweth says.

The winners of the award are stratified in categories or peer groups that represent hospitals throughout the country, and include 25 teaching hospitals with cardiovascular residency programs, 45 teaching hospitals without cardiovascular residency programs, and 30 community hospitals.

The study data includes Solucient’s Diagnostic Related Group and hospital databases, as well as publicly available MedPAR data. To establish a sample of hospitals that were relatively uniform in cardiac patient volume, the analysis was restricted to acute care, non-federal hospitals that met minimum volume criteria in each year -- 1998 and 1999:

• at least 100 reported Medicare cases of acute myocardial infarction (AMI)
• at least 125 reported Medicare patients in the PTCA diagnostic group
• at least 125 Medicare patients in the CABG group

Hospitals that met these volume criteria were then analyzed according to the following measures:

1. Risk-adjusted medical (AMI) 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. Combined risk-adjusted post-operative infection index (post-operative is defined by the presence of surgical discharge DRG); Risk-adjusted post-operative hemorrhage index; and Percentage of PTCA patients with CABG surgeries during the same admission
6. Percentage of CABG patients with internal mammary artery use
7. Severity-adjusted average length of stay
8. Wage and severity-adjusted average cost

For a list of the “Solucient 100 Top Hospitals: Cardiovascular Benchmarks for Success” winners and a summary of the report, visit http://www.100TopHospitals.com. Copies of the study can be purchased by calling Solucient at (800) 568-3282.

Solucient is the leading source of health care intelligence and benchmark information, powering health care decisions for providers, payers, consultants, employers, and pharmaceutical companies. Formed by the recent merger of HCIA-Sachs and HBSI, Solucient offers software and results-oriented information to grow business, contain costs and deliver quality care. Solucient's robust information helps benchmark performance across the continuum of care.

Solucient 100 Top Cardiovascular Hospitals, 2001

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Kerry Lydon-Minton, Public Relations Manager
Solucient LLC
Phone: (847) 475-7526 ext. 2112
klydon@solucient.com

Jean Chenoweth, Executive Director
Solucient 100 Top Hospitals Program
Phone: (734) 669-7941
Fax: (734) 769-6544
jchenoweth@solucient.com