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Home > Studies > 2002 Cardiovascular study > Methodology 100 Top Hospitals®: Cardiovascular
Benchmarks for Success — 2002
Methodology
THE DATA: Data used in calculating the clinical and average cost measures for the Solucient Cardiovascular Benchmarks for Success study are based on the publicly available MedPAR (Medicare Provider Analysis and Review) data set, which contains information on the approximately 12 million Medicare discharges from the nation's acute care hospitals annually. For all clinical performance measures, we used the most recent two years of data available, 2000 and 1999. For the cost and length of stay measures, we used 2000 data only.
The data used in the Solucient 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.
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 the Solucient 100 Top Hospitals: Cardiovascular Benchmarks for Success study, we focused on hospitals that treat a broad spectrum of cardiology patients, from those requiring solely medical management to those needing an angioplasty or open heart procedure. As such, we included all hospitals that had, for both 1999 and 2000, at least 30 unique cases in each of the following groups, as defined below:
- acute myocardial infarction (AMI)
- congestive heart failure (CHF)
- percutaneous transluminal coronary angioplasty (PTCA)
- 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 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, listed below, are described in detail below.
- Procedure Volume Threshold
- Risk-Adjusted Medical Mortality (includes risk-adjusted AMI patient mortality index and risk-adjusted CHF patient mortality index)
- Risk-Adjusted Surgical Mortality (includes risk-adjusted CABG patient mortality index and risk-adjusted PTCA patient mortality index)
- Risk-Adjusted Complications Index (includes post-operative hemorrhages and post-operative infections)
- Percentage of CABG Patients with Internal Mammary Artery Use
- Severity-Adjusted Average Length of Stay
- 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. First, each hospital was given a single score for each of the seven measures. These scores were then summed to arrive at a total score for each hospital within each of the three peer groups.
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Methodology