Journal article
Provider profiling and quality improvement efforts in coronary artery bypass graft surgery: the effect on short-term mortality among Medicare beneficiaries
Medical care, Vol.41(10), pp.1164-1172
10/2003
DOI: 10.1097/01.MLR.0000088452.82637.40
PMID: 14515112
Abstract
In the last decade, a few states or regions in the United States have initiated efforts to publicly disseminate coronary artery bypass graft (CABG) surgery outcomes and/or formally initiate quality improvement programs for CABG surgery.
To compare CABG mortality rates and changes in CABG mortality rates in regions with quality improvement/public dissemination efforts with the remainder of the country.
Medicare data from 1994 to 1999 were used to develop a logistic regression model that predicts patient mortality for CABG surgery on the basis of preoperative patient risk factors and region of the country.
In-hospital, 30-day, and in-hospital/30-day mortality adjusted for preoperative patient risk factors.
Four of the 5 regions with quality improvement/public dissemination programs had significantly lower unadjusted in-hospital/30-day, in-hospital, and 30-day mortality than the remainder of the country. The odds ratio for risk-adjusted mortality for the 6-year period in all study regions combined was significantly lower (odds ratio [OR], 0.79; 95% confidence interval [CI], 0.73-0.85) than in the remainder of the United States. The odds ratio was also significantly lower for each year and for the 6-year time period in New York (OR, 0.66; 95% CI, 0.57-0.77) and Pennsylvania (OR, 0.79; 95% CI, 0.73-0.86). The change in risk-adjusted mortality between 1994 and 1999 remained essentially constant for all regions except New Jersey, the only region to initiate their program during the study period, which exhibited a significant reduction in risk-adjusted mortality.
Public dissemination of outcomes data/formal region-wide quality improvement initiatives appear to be associated with lower risk-adjusted mortality rates for CABG surgery.
Details
- Title: Subtitle
- Provider profiling and quality improvement efforts in coronary artery bypass graft surgery: the effect on short-term mortality among Medicare beneficiaries
- Creators
- Edward L Hannan - Department of Health Policy, Management, and Behavior, University at Albany School of Public Health, Albany, New York, USA. elh03@health.state.ny.usMary S Vaughan SarrazinDonna R DoranGary E Rosenthal
- Resource Type
- Journal article
- Publication Details
- Medical care, Vol.41(10), pp.1164-1172
- Publisher
- United States
- DOI
- 10.1097/01.MLR.0000088452.82637.40
- PMID
- 14515112
- ISSN
- 0025-7079
- eISSN
- 1537-1948
- Language
- English
- Date published
- 10/2003
- Academic Unit
- Health Management and Policy; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984063121602771
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