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Using Cardiac Surgery Mortality Measures
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Background

The Cardiac Surgery “Mortality” measures on this web site are designed to provide patients and their families with important information about coronary artery bypass graft (CABG) surgery outcomes in New Jersey hospitals. This information is intended to help you make decisions about where to receive the best treatment if you are undergoing heart bypass surgery and to encourage you to ask your doctors questions. The measures also provide New Jersey hospitals and surgeons with data they can use in assessing how well they are providing quality of care to patients who undergo bypass surgery.

For more detail, view the Cardiac Surgery in NJ 2009 Report, which is based on 2009 data.

Question What quality measures are used in this section?

Answer Using New Jersey data, NJDOH calculated the mortality or death rates of patients in New Jersey hospitals who died in the hospital after having coronary artery bypass graft (CABG) surgery or after being discharged from the hospital but within 30 days of the surgery. Mortality rates are considered outcome of care measures because they measure the results of the treatment.

Another measure contained on the web site is the number of cases at each NJ hospital licensed to perform CABG surgery.  The number of cases is also an outcome measure.

In addition to these two measures, the Cardiac Surgery in New Jersey report contains more hospital information as well as quality measures on cardiac surgeon performance.

Question Where does the data come from?

Answer NJ DOH collects data on patients undergoing open heart surgery at 18 New Jersey hospitals designated to perform heart surgery. This data is submitted by these 18 hospitals. Of these patients, 4,497 had CABG surgery with no other major surgery during the same admission in 2009.

Question How do you know that the data is accurate?

Answer A sample of 100 cases per hospital is audited each year by an outside vendor. This means that this vendor reviews and validates the data for accuracy and consistency.

Question Why don’t you use data from the current year?

Answer The information on this web site and in the report is based on the most recent year for which a complete, audited data set is available. In order to calculate a more reliable CABG surgery mortality rate, DOH matches the data collected from the hospital against the hospital discharge data (the Uniform Bill, commonly known as UB data) and again against the state’s death registry. This process of ‘validating’ the data takes time. Also, collecting death records from patients living outside of New Jersey as well as other factors can slow down the process.

Note that hospital data on the web site are from 2009.

Question Since some hospitals have sicker patients than others, how can you compare their rates?

Answer NJ DOH analyzes the data, taking into account the patient’s health status before surgery as well as a number of patient characteristics that can affect the health of a patient, such as age, ethnicity, race, gender, health condition, and previous operations. This process is a statistical method known as “risk adjustment” and allows for fair comparisons among hospitals and surgeons treating patients with differing characteristics, different illnesses, and different levels of sickness. It ‘levels the playing field’ by standardizing the data.

Question Why aren’t all NJ hospitals included?

Answer Not all NJ hospitals are licensed to perform bypass surgery. NJ DOH must grant hospitals' certification to perform such surgery based on stringent requirements. Only a few hospitals meet the requirements to qualify for certification. There are currently 18 NJ hospitals licensed to perform this surgery.

Question Can I use the information to draw conclusions about where to go for bypass surgery?

Answer The analysis is accurate for the data year being analyzed, 2009. However, the data may not reflect the hospital’s current performance, which may have improved since then. Ask your doctor and/or hospital for more current information.

Question Should I only go to the hospitals that have mortality rates that are below average?

Answer Not necessarily. There are many factors to consider in determining the best hospital for you. You will want to go to those hospitals that have had experience treating patients who have had medical conditions similar to yours. Before making up your mind, you should discuss the CABG surgery mortality rates with your physician, who is usually a cardiologist and will refer you to a cardiac surgeon for surgery. The cardiologist’s knowledge and expertise will be valuable in helping you make a decision.

Question Is it better to go to a hospital with a high number of cases?

Answer National studies have demonstrated that, in general, hospitals with higher volumes have better results. However, some hospitals with a high number of cases have relatively high mortality (death) rates, while others with a low number of cases have lower mortality rates.

Remember: low mortality rates mean fewer deaths and better outcomes.

 

 Data Table

 Basic Facts on Cardiac Surgery in New Jersey

 Using the Information on this Website

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Last Modified: Monday July 01 2013