Media Release

FOR: Immediate Release
DATE: September 8, 1999
CONTACT: Robert J. Marshall, PhD 401-222-2231

Health Consultant Reports on Cardiac Care in Rhode Island

Providence - The Rhode Island Department of Health (HEALTH) released a special report on cardiac care provided by hospitals in the state. This report, based on an analysis conducted by Michael L. Terrin, MD, a consultant with Clinical Trials & Surveys Corporation (C-TASC) in Baltimore, MD, summarized rates of death, complications and other outcomes for hospital-based cardiac services during 1995 to 1997. The services include: Coronary Angiography (X-rays of blood vessels in the heart), Angioplasty, or PTCA (unblocking arteries in the heart without surgery) and Coronary Artery Bypass Graft, or CABG (surgically bypassing a blocked artery in the heart).

The major findings for the 1995-1997 period include:

• Hospitals in Rhode Island performed 17,964 angiograms, 5,955 PTCAs and 3,503 CABGs.
• The rates for 4 serious complication of angiograms (including stroke, emergency surgery, heart attack and death within 24 hours) were each below 1%; differences among the 5 hospitals that do angiograms were not significant.
• The rates for the same 4 serious complications of PTCA were each 1% or less; differences among hospitals were not significant, with the exception that Rhode Island Hospital had a higher rate of emergency surgery (1.0%) compared to Miriam Hospital (0.5%).
• In-hospital death rate for PTCA in Rhode Island is 1.41%. Deaths rates reported in other studies are as follows: American College of Cardiology database (1.66%), New York State (0.89%); six northern New England regional hospitals (0.99%). Differences between Miriam Hospital and Rhode Island Hospital were not significant.
• In-hospital death rates for CABG in Rhode Island is (3.0%). Death rates reported in other studies are as follows: New Jersey (3.3%), New York (2.5%), Pennsylvania (3.8%) and the Society of Thoracic Surgeons national database (2.8%). After using a recognized method to adjust for patient severity, there were virtually no differences between Miriam Hospital and Rhode Island Hospital.
• Physicians who perform 150 or more CABG procedures per year had a lower death rate (2.4%) than those performing fewer operations (4.6%)

"This analysis shows the value of monitoring quality of health care in Rhode Island," said Dr. Patricia A. Nolan, State Director of Health. "Rhode Island stacks up pretty well against other state and regional benchmarks. There are a couple of areas that need more attention--such as the complication rates of physicians who don't do a lot of procedures." As to how this information will be used, she said, "The public now has information that helps them make decisions about health care. Furthermore, we expect hospitals will continue to use this information as part of their quality improvement programs. Finally, HEALTH will continue to monitor the quality of care and consider relevant changes in policy and regulation."

The analysis and report emanated from a decision in 1993 to increase the number of cardiac catheterization laboratories at Rhode Island Hospital and Miriam Hospital. The approval by HEALTH came with a specific condition requiring an evaluation of the utilization and future need for cardiac services in Rhode Island. The report was prepared in consultation with the Cardiac Services Advisory Committee--consisting of HEALTH, cardiologists, cardiac surgeons, hospital administrators and consumer representatives from the Rhode Island area.

For an explanation of the Cardiac Registry, click here.

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Department of Health Website: www.health.state.ri.us