Trenton, NJ 08625-0360
May 15, 2000
TRENTON - New Jersey's statewide mortality rate for patients undergoing coronary artery bypass graft surgery continued to decline in 1998, reaching its lowest point since the state began reporting cardiac surgery data, Health and Senior Services Commissioner Christine Grant announced today.
The state's third report card showed that 8,377 bypass surgeries were performed in 1998 and 218 patients died, for a statewide mortality rate of 2.60 percent. New Jersey's mortality rate has dropped nearly 40 percent since 1994, based on risk-adjusted data reflecting the fact that death rates have been declining while more patients are facing surgery with more serious health problems.
"We hope the report card answers consumers' questions about this common type of surgery, and helps spark a good physician-patient discussion about available treatment options," explained Commissioner Grant.
"By releasing this data, we're also encouraging hospitals to keep searching for ways to improve their cardiac surgery programs. This important work can save lives," she added.
The Commissioner released the report card at a press event today also attended by Dr. Charles Dennis and Dr. Alfred Casale, who have worked closely with the department on data quality oversight and improvement for the cardiac surgery report card.
Dr. Dennis is chair of the Commissioner's Cardiovascular Health Advisory Panel (CHAP), chair of the Department of Cardiology at Deborah Heart and Lung Center and president of the American Heart Association Heritage Affiliate. Dr. Casale is a member of the CHAP, chief of cardiothoracic surgery, General Hospital at Passaic, and an associate chief of cardiac surgery at the Atlantic Health System.
The report card, Cardiac Surgery in New Jersey, 1998, shows that two of the 14 cardiac surgery hospitals had death rates significantly below the statewide average - Morristown Memorial Hospital, which has been in this category in all three cardiac surgery report cards; and St. Francis Medical Center in Trenton, which reported no deaths among its 238 surgeries.
Two hospitals had significantly above-average risk-adjusted mortality rates - Newark Beth Israel Medical Center and Cooper Hospital/University Medical Center.
The remaining 10 hospitals had risk-adjusted mortality rates that were not significantly different from the statewide average.
All hospital data were risk-adjusted to account for the fact that hospitals across the state treat diverse populations. In effect, risk-adjusting gives "extra credit" to hospitals that served patients who were more ill prior to surgery.
The statewide mortality rate of 2.60 percent in 1998 compares with a rate of 3.37 for the 1996-1997 report card, and 3.75 for 1994-1995. However, to determine the true decline in statewide mortality rates since 1994, the department risk-adjusted the data to account for the fact that more high-risk patients were undergoing surgery in the later years of reporting. This yields a risk-adjusted, statewide mortality rate of 4.0 percent in 1994 and 2.41 in 1998, or a decline of nearly 40 percent.
Unlike the previous two report cards, the 1998 guide includes only one year's data and no performance reports on individual surgeons.
In 1998, for the first time, all hospitals used one standard system to report data on patient risk profiles. This system, used by the Society of Thoracic Surgeons, allows the department to include more patient risk factors in calculating performance data. In switching to the new system, the department decided to limit the report to one year's data. The next report will cover 1998 and 1999.
Limiting the report to one year's data meant many individual surgeons did not have the high volume of cases the department needed to develop statistically precise estimates of each surgeon's performance. The next guide will give performance data on surgeons performing at least 100 procedures at one hospital in 1998-1999.
The report provides data on in-hospital mortality rates for isolated bypass surgery, the most common type of heart surgery procedure. In an isolated bypass, no other major heart procedure is performed at the same time.