NEW-YORK STATES CARDIAC-SURGERY REPORTING SYSTEM - 4 YEARS LATER

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 h ospitals were subdivided into three groups on the basis of their perfo rmance in 1989. The risk-adjusted mortality for each of the three grou ps was computed for 1992 and compared with their 1989 mortality. The r esults indicate that all groups of providers exhibited large reduction s in the risk-adjusted mortalities, with the groups that showed the hi ghest initial mortalities manifesting the most improvement. However, t he 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-a djusted mortality observed in 1989, the risk-adjusted mortality decrea sed 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 mortal ities of the three groups were all significantly different from one an other in 1989, but were not significantly different from one another i n 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.-