Regional Hospitals Competitive in Heart Care
Regional Hospitals Competitive in Heart Care
April 17, 2000 -- With heart procedures such as bypass surgery and angioplasty, emergency treatment and travel distance are sometimes critical factors. But patients can be assured they will likely fare quite well if they go to a regional hospital for treatment.
A new study shows that over the past two decades, the death rates in small, so-called 'low-volume' hospitals (those that perform fewer than 200 such procedures yearly) has improved considerably. Death rates in regional hospitals are often nearly equal those of high-volume hospitals -- those that perform many more such procedures in a year's time.
Angioplasty is a procedure that opens up blocked arteries to relieve chest pain and prevent heart attack. When angioplasty is unsuccessful, bypass surgery -- creating detours around blockages -- is the next step.
There's been much debate in recent years about whether low-volume hospitals should even be performing these procedures.
"We've known for a long time that high-volume hospitals have better outcomes for [angioplasty] than low-volume hospitals," author Vivian Ho, PhD, tells WebMD. "This paper shows that the disparity has narrowed substantially over time." Ho is assistant professor of economics and management at the John M. Olin School of Business at Washington University, in St. Louis. Her study appears in this month's issue of the American Heart Association's journal Circulation.
In her analysis, Ho looked at almost 356,000 files dating from 1984 to 1996, all from patients who had angioplasty in California hospitals. She found that from 1984 to 1987, the death rate in small hospitals was 2.5%. Bigger hospitals had only a 1.3% death rate.
But later, by 1993 to 1996, smaller hospitals' death rate had narrowed to 1.7% while the rate in larger hospitals remained unchanged.
Bypass surgery rates also fell. From 1984 to 1987, the small hospitals' death rate was more than 12%, while high-volume hospitals' rate was about 7%. From 1993 to 1996, however, the death rate in smaller hospitals fell to under 5%. Larger hospitals had a death rate over 3%.
Increasingly better, easier-to-use technology may be one reason why the gap is narrowing, says Ho. Medical conferences that give all cardiologists access to important information also help equal the playing field. "Another possibility is that physicians trained at higher volume hospitals are taking positions at low-volume hospitals," she says. "If that's the case, it does argue that lower-volume hospitals could become as good as high-volume hospitals."
With Affairs of the Heart, Hospital Size Doesn't Matter (Too Much)
April 17, 2000 -- With heart procedures such as bypass surgery and angioplasty, emergency treatment and travel distance are sometimes critical factors. But patients can be assured they will likely fare quite well if they go to a regional hospital for treatment.
A new study shows that over the past two decades, the death rates in small, so-called 'low-volume' hospitals (those that perform fewer than 200 such procedures yearly) has improved considerably. Death rates in regional hospitals are often nearly equal those of high-volume hospitals -- those that perform many more such procedures in a year's time.
Angioplasty is a procedure that opens up blocked arteries to relieve chest pain and prevent heart attack. When angioplasty is unsuccessful, bypass surgery -- creating detours around blockages -- is the next step.
There's been much debate in recent years about whether low-volume hospitals should even be performing these procedures.
"We've known for a long time that high-volume hospitals have better outcomes for [angioplasty] than low-volume hospitals," author Vivian Ho, PhD, tells WebMD. "This paper shows that the disparity has narrowed substantially over time." Ho is assistant professor of economics and management at the John M. Olin School of Business at Washington University, in St. Louis. Her study appears in this month's issue of the American Heart Association's journal Circulation.
In her analysis, Ho looked at almost 356,000 files dating from 1984 to 1996, all from patients who had angioplasty in California hospitals. She found that from 1984 to 1987, the death rate in small hospitals was 2.5%. Bigger hospitals had only a 1.3% death rate.
But later, by 1993 to 1996, smaller hospitals' death rate had narrowed to 1.7% while the rate in larger hospitals remained unchanged.
Bypass surgery rates also fell. From 1984 to 1987, the small hospitals' death rate was more than 12%, while high-volume hospitals' rate was about 7%. From 1993 to 1996, however, the death rate in smaller hospitals fell to under 5%. Larger hospitals had a death rate over 3%.
Increasingly better, easier-to-use technology may be one reason why the gap is narrowing, says Ho. Medical conferences that give all cardiologists access to important information also help equal the playing field. "Another possibility is that physicians trained at higher volume hospitals are taking positions at low-volume hospitals," she says. "If that's the case, it does argue that lower-volume hospitals could become as good as high-volume hospitals."
