Report on Coronary Artery Bypass Surgery Shows Consistent Quality Care Throughout New York State

Overall Risk–adjusted Mortality Rates from CABG Surgery Remain Low

Albany, November 7, 2002 – A newly–released State Health Department report shows that, overall, New Yorkers who need cardiac surgery are receiving consistently high quality care, Dr. Antonia C. Novello, M.D., M.P.H., Dr.P.H. announced today.

The latest Coronary Artery Bypass Graph (CABG) Surgery report shows a statewide CABG surgery mortality rate of 2.24 per 100 patients in 1999, among the lowest ever reported in New York. The rate also represents a substantial improvement over the 3.52 per 100 rate recorded in 1989, when the Department first began reporting CABG surgery outcomes.

Commissioner Novello said, "Under Governor Pataki's leadership, the Department of Health is working effectively and collaboratively with health care providers throughout New York to ensure the ongoing delivery of high quality cardiac surgery to patients. We're proud that New York continues to lead the way in health care advances."

The State Health Department report provides risk–adjusted mortality rates for each of the 33 hospitals approved to provide coronary artery bypass surgery in New York State. To ensure that mortality rates among hospitals and surgeons, are truly comparable, the Department of Health collects and computerizes information on more than 40 patient risk factors that can affect surgery outcome and risk of death for individual patients and "risk adjusts" hospitals' rates. Mortality rates are also published for surgeons who performed the procedures during the three–year period 1997–1999.

Hospitals use these statistics to measure their individual CABG surgery outcomes against the statewide average, and the results of other hospitals with cardiac surgery programs. The CABG data help hospitals evaluate their programs and make necessary improvements. The statistical measures have proved to be a useful quality improvement tool for hospitals and are a major factor contributing to the 36 percent decrease in CABG mortality since 1989.

The risk–adjusted mortality rates for 1999 range from 0.68 to 7.00 per 100 patients. Two hospitals, St. Peter's Hospital in Albany and St. Francis Hospital in Roslyn, had risk–adjusted bypass surgery death rates significantly lower than the statewide average of 2.24 percent. St. Peter's performed 605 coronary bypass surgeries with three deaths for a risk–adjusted morality rate of 0.68 per 100 cases and St. Francis performed 1,804 coronary bypass procedures with 23 deaths for a risk– adjusted mortality rate of 1.29 per hundred cases.

One hospital, University Hospital of Brooklyn, had a risk–adjusted mortality rate of 7.00 in 1999, significantly higher than the statewide rate. The hospital has taken steps, based on advice from the New York State Cardiac Advisory Committee, to improve patient outcomes.

A total of 18,116 coronary bypass surgeries were performed statewide in 1999, down from 18,814 in 1998 and a high of 20,220 in 1997. This is the second consecutive year that bypass surgery volume has declined in New York State, mirroring a national trend. The trend is attributed, in part, to the availability and expanded use of angioplasty.

When comparing the mortality rates for hospitals over the full three–year period 1997–1999, four hospitals achieved risk–adjusted mortality rates significantly below the statewide average of 2.20 percent: St. Joseph's Hospital Health Center in Syracuse, with a three–year risk adjusted cardiac surgery death rate of 0.82 percent; Winthrop University Hospital in Mineola, with a three–year rate of 1.21 percent; St. Francis Hospital, which had a three–year rate of 1.55 percent; and Rochester General Hospital, at 1.61 percent. Risk–adjusted mortality rates at five hospitals were substantially above average: Lenox Hill Hospital in New York City experienced a three–year death rate of 2.90 percent; Buffalo General Hospital, 3.09 percent; St. Vincent's Hospital and Medical Center in Manhattan, 4.10 percent; Arnot Ogden Memorial Hospital in Elmira, 4.38 percent; and University Hospital of Brooklyn, 5.33 percent.

Detailed statistical analysis of the information is carried out under the guidance of the New York State Cardiac Advisory Committee, composed of recognized cardiologists, surgeons and other specialists from New York and other states. A comprehensive report on 2000 data is anticipated within the next several months.

The Health Department will mail copies of its cardiac surgery report to all hospitals and cardiologists in the State. The booklets also will be made available to public libraries and the data will be posted on the Health Department's World Wide Web site (www.nyhealth.gov). Copies of the report may be obtained by writing to: Cardiac Report, Box 2000, Albany, NY 12220.

11/7/02—122 OPA