News Release | 1993 | CABG

Consumer Guide to Coronary Artery Bypass Graft Surgery

FOR IMMEDIATE RELEASE

Contact: Joe Martin, Communications Director
717-232-6787 or

Harrisburg, PA - June 9, 1998

- While the average charge for a coronary bypass operation in Pennsylvania rose by nearly 10% from 1990 to 1991, the rate of increase dropped sharply to 6.2% in 1992 and 4.6% in 1993, according to figures released today by the Pennsylvania Health Care Cost Containment Council. In addition, while the number of bypass patients with significant risk factors remained about the same, the mortality rate for those patients declined. The overall mortality rate for coronary bypass patients included in the Council's reports dropped from 3.9% in 1990 to 2.9% in 1993. The figures were released in conjunction with the publication of the latest Consumer Guide to Coronary Artery Bypass Graft Surgery.

"The Council's first coronary bypass report was released in late 1992," said Ernest J. Sessa, executive director of the Cost Containment Council. "Therefore, the first opportunity for doctors and hospitals to respond to the issues raised in that report was 1993: the year we have examined in this new report. That hospital charges have been restrained and mortality rates have declined suggests that the process of public reporting is having a positive impact."

Other Highlights

While only Wilkes-Barre General Hospital/WVHCS in 1991 and St. Vincent Health Center in 1992 actually lowered their charges, five hospitals reduced their charges in 1993: St. Luke's Hospital of Bethlehem, Western Pennsylvania Hospital, Penn State University Hospital /Hershey, Shadyside Hospital, and St. Vincent Health Center.
Among the hospitals with the lowest overall increases in the average charge for a coronary bypass operation (1990-93): St. Luke's Hospital of Bethlehem (1.6%); Western Pennsylvania Hospital (6.3%); Wilkes-Barre General Hospital/WVHCS (9.3%); and St. Francis Central Hospital (9.9%).
By 1993, five of the seven Pennsylvania hospitals which had significantly more deaths than expected in 1990 (Graduate Hospital, Harrisburg Hospital, Lehigh Valley Hospital, St. Francis Medical Center, and York Hospital) were reporting the same number of patient deaths as expected according to the Council's methodology.
For the fourth consecutive year, Allegheny General Hospital was reported with significantly fewer deaths than expected.
For the second year in a row, Robert Packer Hospital of Sayre, PA had the lowest average charge in the state.
St. Luke's Hospital in Bethlehem, PA increases their charges by only 2% from 1990 to 1993, lowest in the state.
Altoona Hospital and Temple University Hospital of Philadelphia were the two hospitals besides Allegheny General Hospital to have significantly fewer deaths than expected in 1993.

The fourth annual Consumer Guide to Coronary Artery Bypass Graft Surgery reports patient mortality rates for 177 Pennsylvania cardiac surgeons who performed coronary artery bypass graft surgery in calendar year 1993, and for the 41 Pennsylvania hospitals where the surgeries were performed. The report also lists the average amount the hospitals charged for the procedure.

In developing the expected numbers for hospitals and cardiac surgeons, the Council takes into account the key health factors, otherwise known as risks, for each patient who underwent bypass surgery. The rating system then gives a certain weight to each risk factor, according to its contribution to patient mortality, based on the experiences of more than 17,00 patients who had bypass surgery in 1993. For instance, a patient who had a previous bypass operation and who was in cardiogenic shock would have a greater risk of dying than a patient with no significant risk factors. Only risk factors which had a significant impact on patient mortality were included in the report.

"Our system takes into account the fact that not all cardiac surgeons and CABG hospitals operate on the same kinds of patients, that some patients are sicker or at higher risk than others," said Mr. Sessa. "By adjusting for the risk of bypass patients, the system levels the playing field by giving "extra credit" to doctors and hospitals who treat high risk patients. In this way, comparisons among providers can be made in a more uniform and consistent manner."

The information is grouped in the report by hospital, and by cardiac surgeons who practiced in that hospital. Only physicians or hospital with more than 30 operations received a rating. Also included is a three-year comparative table listing the statistics for hospitals and surgeons with a total of 30 or more cases in the each of the three reports (1991, 1992, 1993).

The 1993 report contains several new sections. One section shows the rate of increases in charges for coronary bypass surgery from 1990 to 1993 for each hospital. The second section provides a breakdown by payer or insurance category for CABG patients. This section allows for comparisons among payors for average length of hospital stay, risk-adjusted mortality rates, charges per day, and the percentage of CABG patients. Finally, a section titled An Important Message For Women about Heart Disease has been added to provide additional educational information.

Mr. Sessa also noted that in developing this report, the Council sought and received a great deal of input from the medical community, consumers, purchasers and insurers. The Council also received valuable input from its Technical Advisory Group, a Council committee of health research experts and physicians.

Copies of the reports are free and can be ordered by calling or writing the Council. Contact: Joe Martin, Press Secretary (717) 232-6787.