U.S. trends in CABG hospital volume: the effect of adding cardiac surgery programs.
Hospital coronary artery bypass graft (CABG) volume is inversely related to mortality--with low-volume hospitals having the highest mortality. Medicare data (1992-2003) show that the number of CABG procedures increased from 158,000 in 1992 to a peak of 190,000 in 1996 and then fell to 152,000 in 2003, while the number of hospitals performing CABG increased steadily. Predictably, the proportion of CABG procedures performed at low-volume hospitals increased, and the proportion in high-volume hospitals declined. An unintended consequence of starting new cardiac surgery programs is declining CABG hospital volume--a side effect that might increase mortality.
Wilson
Chad T
CT
Massachusetts General Hospital, Boston, USA. ctwilson@partners.org
Fisher
Elliott S
ES
Welch
H Gilbert
HG
Siewers
Andrea E
AE
Lucas
F Lee
FL
D000368:Aged; D000369:Aged, 80 and over; D002300:Cardiac Care Facilities / Q000706:statistics & numerical data / Q000600:supply & distribution; D016507:Cardiology Service, Hospital / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D001026:Coronary Artery Bypass / Q000191:economics / Q000401:mortality / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery; D019538:Health Care Surveys; D017052:Hospital Mortality / Q000639:trends*; D006752:Hospital Planning; D006801:Humans; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data; D038801:International Classification of Diseases; D006278:Medicare / Q000706:statistics & numerical data; D011357:Product Line Management; D015397:Program Evaluation; D011787:Quality of Health Care; D013503:Surgery Department, Hospital / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014600:Utilization Review