A study in the Nov. 24 issue of the Annals of Internal Medicine found that hundreds of lives could be saved annually if the lowest performing hospitals for coronary artery bypass graft (CABG) surgery performed as well as top-ranking hospitals.
Researchers also found that women undergoing CABG surgery suffer higher relative mortality rates than men across all hospitals, with the greatest differential among lowest ranking hospitals.
The study ranked U.S. hospitals conducting CABG surgery into four performance tiers and determined whether there were overall and gender-specific differences in the mortality rates across the tiers.
Researchers led by Steven D. Culler, PhD, associate professor at the Rollins School of Public Health, Emory University, found that the average risk-adjusted mortality rates among Medicare beneficiaries in 2003 and 2004 ranged from 1.4 percent among the highest performing hospitals, or those in tier 1, to 6.4 percent in the fourth or lowest ranking tier.
“The relative risk of mortality for undergoing CABG surgery in a bottom-tier hospital was 4.4 times that of a top-tier hospital," the authors wrote. “And 75 percent of the observed deaths of either male or female Medicare beneficiaries treated in a tier 4 hospital could be avoided if tier 4 hospitals could improve their performance to the average performance of top-tier hospitals.”
The gender differential against women significantly increased from 0.68 percent in tier 1 to 2.67 percent in tier 4.
The study also noted that the difference in relative mortality rates between the highest and lowest performing hospitals was greater than the reduction in mortality rates seen over the past ten years as the result of clinical advances in CABG surgery.
The study was funded and conducted by Cardiac Data Solutions, which provides consultative and other services to hospitals, physicians, payors, manufacturers and the financial community.