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TRENTON
- The Department of Health and Senior Services announced today that
New Jersey's statewide mortality rate for patients undergoing coronary
artery bypass graft surgery held steady in 1999, remaining essentially
unchanged from the previous cardiac surgery report card.
Cardiac
Surgery in New Jersey: A Consumer Report also includes performance
data both for individual surgeons and for the 14 hospitals performing
cardiac surgery during the report period. This is the fourth cardiac
report issued by the New Jersey Department of Health and Senior
Services, in cooperation with the Commissioner's Cardiovascular
Health Advisory Panel.
According
to the report released today, New Jersey's statewide mortality rate
was 2.89 percent in 1999, compared with the 1998 rate of 2.60 percent.
The two rates are not considered to be statistically different.
"Since
1994, New Jersey mortality rates have dropped steadily. The 1999
data does not precisely fit this trend," said acting Health
and Senior Services Commissioner George T. DiFerdinando, Jr., M.D.
"However, it's too early to tell if mortality rates have truly
reached a plateau or whether the downward trend will continue. We
need two more years' data to get a clearer picture of the trend."
Cardiac
surgery mortality rates are risk-adjusted to reflect the fact that
hospitals and physicians across the state treat diverse populations,
and that the patient pool statewide has changed since 1994. Generally
speaking, over time, the patient pool has come to surgery with more
health conditions that put patients at risk of dying. In effect,
risk adjustment gives "extra credit" to hospitals and
physicians treating sicker patients.
When
statewide mortality data are risk-adjusted over the six years of
data reporting, it shows the death rate has dropped by 36 percent
- from 4.02 in 1994 to 2.56 in 1999. In 1998, the risk-adjusted
rate was 2.48 percent, which is not statistically different from
the 1999 rate.
The
fourth report includes statewide and hospital-by-hospital data based
on 8,108 bypass procedures. There were 234 deaths before hospital
discharge. This year's report also includes surgeon-specific performance
data for 1998 and 1999 combined. Surgeon performance was not included
in last year's cardiac surgery report, which covered only 1998.
Two years' data is needed to develop statistically precise estimates
of individual surgeon performance.
According
to the report, one hospital - Jersey Shore Medical Center - had
a risk-adjusted mortality rate that was significantly better than
the state average in 1999. The remaining 13 had rates no different
from the statewide average.
Three
surgeons had below-average mortality rates in 1998 - 1999, three
had above-average rates and the remainder had rates that did not
differ from the statewide average. The report names 52 surgeons
who performed at least 100 bypass operations in one hospital in
1998-1999.
"Through
close collaboration with the medical community, we've been able
to develop a useful report based on sound data," Dr. DiFerdinando
said. "I would like to thank the Cardiovascular Health Advisory
Panel (CHAP) and the Clinical Review Panel for their hard work on
this project."
Dr.
Charles Dennis, chairman of CHAP, is also president of the American
Heart Association Heritage Affiliate and chairman of the Cardiology
Department at Deborah Heart and Lung Center. The department's consultant
on the project is Dr. Edward Hannan, professor and chairman of the
Department of Health Policy and Management, State University of
New York at Albany.
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.
The
report is available on the department's web site, www.state.nj.us/health,
or may be obtained by calling 1-888-393-1062.
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