CABG, PCI Rates Decline in CA

Cheryl Clark, for HealthLeaders Media , June 14, 2011

Parker says the California database has a lot of value for the rest of the county. "We do a pretty good job of showing what's happening in California that probably reflects in a lot of ways what's happening in the nation," he says.

Another important revelation from this report, Parker says, is that patients who undergo CABG are sicker than they were in the past. Additionally, despite fears from surgeons and their organizations that doctors would avoid operating on patients with multiple co-morbidities whose risks of mortality might make their performance look poor, Parker says "there doesn't seem to be any avoidance of the sickest patients."

According to the report, for 2008, no hospital scored better than average in risk-adjusted CABG mortality, but two hospitals, California Pacific Medical Center Pacific campus in San Francisco, and Centinela Hospital in Inglewood had the worst mortality rates, 9.97% and 10.85%.

Only one hospital, Alta Bates Summit Medical Center Summit Campus in Berkeley, had significantly better risk-adjusted post-operative rates of stroke, a rating it repeated since the last report.

However, eight hospitals had the worst performance rating in post-operative rates of stroke: Bakersfield Memorial Hospital, Dominican Hospital in Santa Cruz, Good Samaritan Hospital of San Jose, Providence-Tarzana Medical Center, Scripps Memorial Hospital in La Jolla and Tri-City Medical Center in Oceanside.

Hospitals with low use of internal mammary artery during CABG procedures were Antelope Valley Hospital in Lancaster, Beverly Hospital, Enloe Medical Center in Chico, St. Helena Hospital in St. Helena, and Sutter Medical Center of Santa Rosa.

Parker says that future state reports may illuminate the precise causes of death associated with CABG procedure, for example operator error versus infection.

The agency's report found that despite the decline in both CABG and PCI procedures, the number of licensed hospital catheterization labs continues to increase, from just over 200 in 1988 to nearly 400 in 2008.

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