Medical center at top of California report on bypass graft surgery

UC Davis Medical Center was one of four California hospitals that performed better than expected on coronary artery bypass graft (CABG) surgeries in 2003, according to a report released this week by the Office of Statewide Health Planning and Development.

“These rankings reflect the commitment, strength and excellence that result from the multidisciplinary and collaborative team approach we offer as an academic medical center,” said Nilas J. Young, professor and chief of cardiothoracic surgery at UC Davis Medical Center.

The medical center performed 136 of the bypass surgeries in 2003. No patients died in the hospital or up to 30 days after surgery, for a risk-adjusted mortality rate of zero. Statewide, the mortality rate for patients was 2.91 percent in 2003. California is one of only four states that use clinical data to report on hospital and surgeon outcomes for bypass surgery.

OSHPD’s first mandatory “California Report on Coronary Artery Bypass Graft Surgery (CABG) 2003 Hospital Data” details quality ratings for all 121 California hospitals that performed CABG surgeries in 2003 and shows that 113 hospitals performed as expected, four hospitals performed better than expected and four hospitals performed worse than expected.

“Measurement and public accountability are requisite steps in the quality improvement process,” said OSHPD Director Dr. David Carlisle. “Disseminating hospital performance information is critical to national efforts to close the quality gap. This report is a step toward reducing performance variations to ensure that inpatient care is safe, effective and efficiently delivered.”

Heart bypass surgery is one of the top 10 surgeries in California in terms of cost, number of cases, mortality post-procedure and hospital revenue produced. In 2003, more than 123,000 Californians were admitted to hospitals with coronary artery disease (CAD), which represents 8 percent of all adult non-maternal admissions, making CAD procedures the leading cause of admission to California hospitals in 2003. CABG surgery is performed when there is a chronic build-up of plaque along the linings of the coronary arteries. Blood vessels can become partially or completely blocked by the plaque, leading to heart attacks.

This latest report expands the work of the voluntary California CABG Mortality Reporting Program (CCMRP), which was conducted from 1995 to 2002. The current report, mandated by 2001 legislation, lays the foundation for public reporting of CABG outcomes and highlights the differences in mortality rates for California hospitals. The next report, expected later this year, will additionally report on individual surgeon outcomes.

OSHPD’s mission is to promote health care accessibility for all Californians. The CABG report is available online at www.oshpd.ca.gov.