NEW-YORK STATES CARDIAC-SURGERY REPORTING SYSTEM - 4 YEARS LATER
NEW-YORK STATES CARDIAC-SURGERY REPORTING SYSTEM - 4 YEARS LATER
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DOI：
10.1016/0003-4975(94)91726-4
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发表时间：
1994-12-01
影响因子：
4.6
通讯作者：
CHASSIN, MR
中科院分区：
文献类型：
--
作者：
HANNAN, EL;KUMAR, D;CHASSIN, MR
本研究调查了纽约心脏手术报告系统（1989年至1992年）前4年期间在纽约州进行的冠状动脉旁路移植术相关的风险调整死亡率的变化。为了跟踪一段时间内的表现，外科医生和医院根据1989年的表现被分为三组。计算了1992年这三组中每一组的风险调整死亡率，并与1989年的死亡率进行了比较。结果表明，所有组的供应商都表现出风险调整后的死亡率大幅下降，显示最高的初始死亡率的组表现出最大的改善。然而，1992年的小组排名与1989年相同。例如，当医院分组基于1989年观察到的风险调整死亡率的百分位数时，第1组的风险调整死亡率从2.72%降至2.19%，第2组从4.24%降至2.51%，第3组从7.12%降至2.77%。值得注意的是，1989年三个群体的风险调整死亡率都有显著差异，但在1992年没有显著差异。另一个有趣的发现是，不同供应商集团执行的业务量在4年期间没有实质性变化。
This study examined changes in the risk-adjusted mortality associated with coronary artery bypass grafting procedures performed in New York State during the first 4 years of New York's Cardiac Surgery Reporting System (1989 to 1992). To track performance over time, surgeons and hospitals were subdivided into three groups on the basis of their performance in 1989. The risk-adjusted mortality for each of the three groups was computed for 1992 and compared with their 1989 mortality. The results indicate that all groups of providers exhibited large reductions in the risk-adjusted mortalities, with the groups that showed the highest initial mortalities manifesting the most improvement. However, the group rankings remained the same in 1992 as they were in 1989. For example, when the hospital groups were based on the terciles of risk-adjusted mortality observed in 1989, the risk-adjusted mortality decreased from 2.72% to 2.19% for group 1, from 4.24% to 2.51% for group 2, and from 7.12% to 2.77% for group 3. Notably, the risk-adjusted mortalities of the three groups were all significantly different from one another in 1989, but were not significantly different from one another in 1992. Another interesting finding was that the volume of operations performed by the various provider groups did not change substantially in the 4-year period.-