New AHCPR-Supported Study Reported in JAMA

Press Release Date: July 25, 1995

A study is being published in the July 26 issue of the Journal of the American Medical Association (JAMA), entitled "Evaluation of the Complication Rate as a Measure of Quality of Care in Coronary Artery Bypass Graft Surgery." It finds that hospital rankings based on complication rates for patients who undergo coronary artery bypass graft (CABG) surgery are not a reliable indicator of the quality-of-care that hospitals provide. The study, which was supported by the Agency for Health Care Policy and Research (AHCPR), found that many hospital characteristics that are generally associated with higher quality-of-care were associated with higher complication rates, but with expected or lower-than-expected mortality rates.

Authors of the study speculated on the reasons for this seeming paradox—including the possibility that while hospital deaths are reported consistently, different criteria may be applied for reporting in-hospital complications. They concluded that hospital rankings based on complication rates provide different information than those based on mortality rates. Until more is known about these differences, complication rates should not be used to judge hospital quality of care in CABG surgery.

The study was based on records abstracts for 16,673 patients who underwent CABG procedures at 57 hospitals across the nation and data from the 1991 American Hospital Association Annual Survey. It provides significant new information for health care managers, especially those with managed care systems that provide an increasing portion of medical care in the United States.

For additional information, contact AHCPR Public Affairs: Karen Migdail, (301) 427-1855.