Measure Type: Outcome
he Department of Health and the Cardiac Advisory Committee has collaborated to provide the public with treatment options for cardiovascular diseases. They have conducted studies on the treatment effects of patients with heart diseases. Data on risk factors and mortality rates for Percutaneous Coronary Interventions (PCI) are presented. PCI (also known as coronary angioplasty/balloon angioplasty) is conducted to treat the patient’s arteries in the heart. For example, a patient may have chest pains (causing a block in the arteries) that may be derived from high cholesterol.
The Department of Health has collected data on all of the adults who were residents of New York State undergoing PCI in a hospital setting. Their database does not provide information subsequent to 2004. Risk-adjusted mortality rates (RAMR) were reported on patients undergoing PCI in 48 New York State hospitals. They cross-matched the PCI data with other Department of Health databases (along with a review of the medical record information), to establish consistent interpretations across the hospitals. If the RAMR is lower than the statewide mortality rate, then the hospital had a better performance than the state as a whole. Unfortunately, each hospital has various ways of coding quality care.
The Department of Health also arranges information to the public on Adult Cardiac Surgery. All New York State residents who had coronary artery bypass graft (CABG) surgery or valve surgery (having no other heart surgery during admission into New York State hospitals), were used in their data collection. This information presents hospitals and surgeons with outcomes on their procedures, allowing them to examine their quality care and distinguish areas that need improvement. CABG occurs when the arteries start to harden due to atherosclerotic plaque that builds up in the wall of the arteries. This plaque is mostly made up of cholesterol that will elevate with individuals who are smokers; someone that has high blood pressure; or someone who has diabetes. Valve surgery is given to patients who have problems with their heart valve closing; enabling the blood to move correctly in the heart’s chambers.
It is difficult to determine the results among hospitals since they each have their own way of treating patients. With different billing codes for the risk factors on each hospital, it devalues the reliability on the risk-adjusted mortality measures. When the Department of Health discovers a major coding problem they have the hospital recode their data. All the measures for the risk-adjusted mortality rates on CABG surgeries, valve surgeries, PCI, and pediatric congenital surgeries were derived from the annual reports published by the NYS Department of Health Cardiac Services Program.