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100 Top Cardiovascular Hospitals
1999 Selections Based on CABG, PTCA Performance

HCIA-Sachs announced the results of its first annual 100 Top Cardiovascular Hospitals study. The study identified the best-performing hospitals in each of two categories: "Open-Heart" or Coronary Artery Bypass Graft (CABG) Surgery and "Coronary Angioplasty" or Percutaneous Transluminal Coronary Angioplasty (PTCA). For each category, HCIA-Sachs identified the 100 best-performing hospitals in the U.S.

The 100 Top Cardiovascular Hospitals for CABGs had significantly lower mortality and complication rates than the national peer group and had average costs per case that were some $3,000 per case below the group. On average, patients undergoing a CABG at a 100 Top Cardiovascular Hospital were 20 percent less likely to end up with a tracheostomy.

The 100 Top Cardiovascular Hospitals for PTCA were 20 percent less expensive than the peer group and, on average, did twice as many PTCAs as their peers. Patients undergoing a PTCA at a 100 Top Cardiovascular Hospital were 50 percent less likely to be escalated to a CABG surgery.

The study, based on a computerized review and analysis of more than 12 million Medicare cases, used clinical and financial measures such as average length of stay, risk-adjusted complications and mortality rates, and severity-adjusted costs per case. Additional calculations used to measure efficiency and effectiveness included (i) the measurement of the proportion of CABGs performed at a hospital that resulted in trachestomies and (ii) the frequency that PTCAs resulted in CABGs.

Prior to being ranked in each category, each hospital was placed into one of three peer groups: Teaching Hospitals with Cardiovascular Residency Programs, Teaching Hospitals without Cardiovascular Residency Programs, and Non-Teaching Hospitals. Approximately 700 hospitals that performed at least 80 Medicare CABGs were included in the CABG analysis and approximately 700 hospitals that performed at least 100 Medicare PTCAs were included in the PTCA analysis. (While several hundred hospitals were included in each category, only 34 hospitals were named Top Hospitals for both CABGs and PTCAs.)

While hospitals from across the country were included in the 100 Top Cardiovascular Hospitals, a remarkable four of five CABG programs in Cincinnati were designated as among the 100 Top. Also, five of the seven CABG programs in Pittsburgh earned 100 Top status, as did two of four PTCA programs in Salt Lake City.

"This study is evidence that top-quality care can be delivered in a cost-effective fashion," said Thomas P. May, assistant vice president for HCIA-Sachs and an author of the study. "Cardiovascular services have been at the forefront of hospital cost containment initiatives for years. The hospitals, cardiologists and cardiothoracic surgeons have responded to the challenge in many hospitals across the country and they have raised the bar for performance of CABG and PTCA."

Full details of this study, including the list of winners, noteworthy findings, and methodology, are now available from HCIA in softbound format for $125. You may reserve a copy of the abstract or arrange a custom study comparing your hospital against its peer group and a national benchmark by calling Solucient Customer Service at 1-800-568-3282 and selecting option 5, or by sending an e-mail to pubs@solucient.com.

For more information about the 100 Top Cardiovascular Hospitals, send e-mail to Jean Chenoweth at jchenoweth@solucient.com or call her at (734) 669-7941.

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