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New York State Cardiac Surgery Reporting System Presentation – Hospital Public Reporting Summit May 26, 2004 Donna R. Doran Regulatory and Oversight Environment Regulation in NYS provides broad powers to the Department of Health
Donna R. Doran
Major interest in Access
1 Hannan, van Ryan, Burke et al. Access to Coronary Artery Bypass Surgery by Race/Ethnicity and Gender Among Patients Who Are Appropriate for Surgery,” Medical Care, 1999; 37(1):68-77.
New York Hospital - Cornell
New York Hospital - Queens
NYU Medical Center
St. Luke's - Roosevelt
Univ. Hospital of Brooklyn
2.44 New York State Average
There is at least anecdotal evidence that these changes would not have occurred without the public release of data
1 Peterson et al., The Effects of New York State’s Bypass Surgery Provider Profiling on Access to care and Patient Outcomes in the Elderly, JACC 1998;32:993-9).
Comparing states/regions with QI/Public Dissemination to remainder of Country. Conclusion - Public dissemination of outcomes data/regional QI initiatives appear to be associated with lower RAMR for CABG. (1994-1999 Medicare data)
NY adjusted odds ratio for mortality (vs. US): .67 (significant each year and in total, but relatively constant)
PA also significant each year with overall adjusted OR=.80
2 Hannan EL, Vaughn Sarrazin MS, Doran DR et al., Provider Profiling and Quality Improvement Efforts in Coronary Artery Bypass Graft Surgery: The Effect on Short-Term Mortality Among Medicare Beneficiaries. Med Care 2003;411:1164-1172.
3 Hannan EL, Kilburn H, Lindsey ML et al.., Improving the Outcomes of Coronary Artery Bypass Surgery in New York State. JAMA 1994;271:761-766
2 Hannan EL, Sarrazin MSV, Doran DR, Rosenthal GE. Provider Profiling and Quality Improvement Efforts in CABG Surgery: The Effects on Short-Term Mortality Among Medicare Beneficiaries, Medical Care, 2003;41(10):1164-1172..
7. Hannan EL, Racz MJ, Walford G, Ryan TJ, Isom OW, Bennett E, Jones RH. Predictors of Readmission for Complications of Coronary Artery Bypass Graft Surgery in New York State, Journal of the American Medical Association, 2003;290:773-780.
8. Hannan EL, Racz M, Ryan TJ, McCallister BD, Johnson LW, Arani DT, Guerci AD, Sosa , Topol EJ. "Coronary Angioplasty Volume-Outcome Relationships for Hospitals and Cardiologists", Journal of the American Medical Association 1997;277(11):892-898.
Results are credible
The system is functional/clinically relevant
Results are Available to Public
Cooperative and Committed Providers