Alabama coronary artery bypass grafting Cooperative Project: baseline data. Alabama CABG Cooperative Project Study Group.
BACKGROUND
The Alabama Cooperative CABG Project is a statewide process-oriented analysis of coronary artery bypass grafting (CABG). The purpose of this report is to present the first information generated by this analysis, which will serve as a baseline for subsequent quality improvement projects.


METHODS
Medical records of Medicare beneficiaries from Alabama, a comparison state, and a national random sample who had isolated CABG between July 1, 1995, and June 30, 1996, were examined. Fifty-six demographic, procedural, and outcome variables were abstracted. Quality indicators identified by the Alabama Quality Assurance Foundation Study Group included: internal mammary artery use, prescription of aspirin at discharge, duration of postoperative intubation, use of intraaortic balloon pump, readmission to intensive care unit, hospital readmission within 30 days, return to the operating room for bleeding, and in-patient mortality. Benchmark performance rates for quality indicators reflecting care processes were calculated.


RESULTS
Alabama, the comparison state, and the national sample consisted of 4,092, 2,290, and 1,119 patients, respectively. The processes of care and outcome, including risk-adjusted mortality, for CABG across the state of Alabama are generally similar to other states and nationwide samples. However, there was considerable variation at the local hospital level in Alabama for each quality indicator.


CONCLUSIONS
The data provide a "snapshot" of practice patterns for CABG in Alabama. A specific quality indicator (duration of intubation) was identified as a focus for statewide improvement. Hospital-specific variations in quality indicators suggested opportunities for improvement in other indicators at a number of hospitals.
Holman
W L
WL
The Alabama Quality Assurance Foundation, University of Alabama at Birmingham, Birmingham Veterans Affairs Medical Center, 35294-0007, USA. wholman@holman.cvsr.uab.edu
Peterson
E D
ED
Athanasuleas
C L
CL
Allman
R M
RM
Sansom
M
M
Kiefe
C
C
Sherrill
R G
RG
D000368:Aged; D000369:Aged, 80 and over; D000407:Alabama; D001241:Aspirin / Q000008:administration & dosage; D019985:Benchmarking; D001026:Coronary Artery Bypass / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000401:mortality; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010359:Patient Readmission; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery; D011785:Quality Assurance, Health Care; D012086:Reoperation; D015996:Survival Rate; D015300:Ventilator Weaning
D001241:Aspirin