100 Top Hospitals® Study Shows Strong Link Between Top Performing Hospitals and Continuous Improvement

Increased Survival Trend Strongest Among Solucient 100 Top Hospitals Cardiovascular Winners

EVANSTON, IL – October 25, 2004 – A study by Solucient® identifies a significant new trend for coronary bypass patients: Although they are sicker than ever before, more coronary bypass patients across the nation are surviving surgery, and at higher than anticipated rates. The Solucient 100 Top Hospitals® Cardiovascular award winners are leading the nation in this new trend.

Solucient, the nation’s leading source of information products for the healthcare industry, studied expected and actual mortality for a wide range of coronary artery bypass graft (CABG) patients — from the typical to the most severe — over a six-year period.

The results showed a significant increase in the severity of co-morbidities and complications, which translated into a higher “expected” death rate of five more patients per 1000 by 2003. However, contrary to this expected rise in CABG mortality, the study shows the reverse: a significant decrease in the actual death rate of five patients per 1000 by 2003.

The 100 Top Hospitals Cardiovascular award winners have been most effective at increasing CABG survival. The winners have significantly lower crude death rates than non-winners, despite having similar expected death rates.

These findings appear in a new study, the 2004 Solucient 100 Top Hospitals®: Cardiovascular Benchmarks for Success, published today in the Oct. 25 edition of Modern Healthcare magazine.

“Our study suggests that not only are sicker patients undergoing CABG, but hospitals and physicians have also progressively developed ways to raise the survival rate of high-risk patients. Clinicians and hospitals appear to be doing a better job of saving patients with the most severe co-morbidities and complications, which is a tribute to the performance improvement efforts of hospitals across the nation,” said Janet Young, M.D., M.H.S.A., senior clinical scientist at Solucient and author of the study.

“Higher CABG survival rates for significantly sicker patients demonstrate the increasing value hospitals are providing to communities around the nation through performance improvement efforts,” said Jean Chenoweth, senior vice president, performance improvement and 100 Top Hospitals programs, Solucient Center for Healthcare Improvement. “With the advent of public reporting on hospital performance, concerns were raised about possible diminished access of the sickest patients to CABG and other high-risk surgical procedures. This study shows that so far, these concerns may be unfounded. This speaks well for the effectiveness and integrity of our nation’s hospitals and physicians,” she added.

• If cardiovascular services in all acute-care hospitals performed at the same level as the hospitals with the nation's top cardiovascular services, 4,200 additional cardiovascular patients could survive each year; and an additional 1,600 patients could be complication-free.
• Winning hospitals are 35 percent less likely than non-winners to have post-operative infections and 20 percent less likely than non-winners to have post-operative hemorrhage for patients undergoing CABG or percutaneous coronary interventions (PCI).
• Winning hospitals annually perform twice as many bypass surgeries and PCIs, including angioplasties, as their peers.
• Cardiovascular patients at winning hospitals return to everyday life faster than those at non-winning hospitals. Patients at the winning hospitals were released more than a half-day earlier than patients at peer hospitals.
• Average cardiovascular-related costs for benchmark hospitals were nearly 13 percent lower than at peer hospitals.

The sixth edition of the Solucient 100 Top Hospitals®: Cardiovascular Benchmarks for Success study analyzed acute-care hospitals nationwide using detailed empirical performance data from publicly available Medicare MedPAR data and Medicare cost reports. The measures were calculated for three classes of hospitals with the following number of winners in each:

• Teaching with Cardiovascular Residency Programs, 30 winners
• Teaching without Cardiovascular Residency Programs, 40 winners
• Community, 30 winners

Solucient® scored facilities in seven key performance areas: risk-adjusted medical mortality, risk-adjusted surgical mortality, complications, percentage of CABG patients with internal mammary artery use, procedure volume, severity-adjusted average length of stay, and wage and severity-adjusted average cost.

Media Notes:
More information on these studies and other 100 Top Hospitals research is available at www.100tophospitals.com. An executive summary of the 100 Top Hospitals: Cardiovascular Benchmarks for Success study is available to the media by emailing gsexton@solucient.com or by registering at http://www.100tophospitals.com/media/Register.asp.

For a list of this year’s winners, visit http://www.100tophospitals.com/Studies/cardio04/winners/default.asp.

To schedule an interview with Jean Chenoweth, senior vice president, performance improvement and 100 Top Hospital® programs, Solucient Center for Healthcare Improvement, contact Ginny Sexton at (847) 424-4358 or gsexton@solucient.com.

About Solucient
Solucient® is an information products company serving the healthcare industry. It is the market leader in providing tools and vital insights that healthcare managers use to improve the performance of their organizations.

By integrating, standardizing and enhancing healthcare information, Solucient provides comparative measurements of cost, quality and market performance. Solucient's expertise and proven solutions enable providers, payers and pharmaceutical companies to drive business growth, manage costs and deliver high quality care. For more information, visit www.solucient.com.