Long-term quality & outcomes in cardiac surgery

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Table XX – Post-Operative Complications
High Risk
Hispanic
Renal failure/dialysis requirement 1-30 days post dischargeRenal failure/dialysis requirement 31-60 days after 7 dischargeRenal failure/dialysis requirement 61-90 days after 4 dischargeRenal failure/dialysis requirement 91-120 days after dischargeRenal failure/dialysis requirement 121-180 days after dischargeRenal failure/dialysis requirement 181-360 days after dischargeNeurologic deficit persisting greater than 72 hours bleeding/tamponade, graft occlusion, or other cardiac reasonMortality rate: within 1-30 days of procedure if discharged, or if during hospitalization (where procedure was performed)Deep sternal wound infections within 1-30 days post-operative Deep sternal wound infections within 31-60 days after discharge Deep sternal wound infections within 61-90 days after dischargeDeep sternal wound infections within 91-120 days 3 after dischargePleural Effusion within 60-90 days after discharge Pleural Effusion within 91-120 days after dischargePleural Effusion within 121-180 days after dischargePleural Effusion within 181-360 days after Table XX – Medication Utilization
High Risk
Hispanic
Prior MI on a beta-blocker medication during the Beta Blocker Therapy within 24 hours preceding HF and LVSD prescribed beta-blocker therapy.
Discharged on beta blockers Persistent use of beta blockers 1-7 days after Persistent use of beta blockers 8-30 days after Persistent use of beta blockers 31-60 days after Persistent use of beta blockers 61-90 days after Persistent use of beta blockers 91-120 days after Persistent use of beta blockers 121-180 days after Persistent use of beta blockers 181-360 days after Persistent beta-blocker during 180 days following Discharged on a statin or other pharmacologic Persistent use of statin or other pharmacologic lipid-lowering regimen 1-7 days after discharge Persistent use of statin or other pharmacologic lipid-lowering regimen 8-30 days after discharge Persistent use of statin or other pharmacologic lipid-lowering regimen 31-60 days after discharge Persistent use of statin or other pharmacologic lipid-lowering regimen 61-90 days after discharge Persistent use of statin or other pharmacologic lipid-lowering regimen 91-120 days after dischargePersistent use of statin or other pharmacologic lipid-lowering regimen 121-180 days after dischargePersistent use of statin or other pharmacologic lipid-lowering regimen 181-360 days after Persistent use of anti-platelet 1-7 days after Persistent use of anti-platelet 8-30 days after Persistent use of anti-platelet 31-60 days after Persistent use of anti-platelet 61-90 days after Persistent use of anti-platelet 91-120 days after dischargePersistent use of anti-platelet 121-180 days after dischargePersistent use of anti-platelet 181-360 days after The percentage of patients with atrial fibrillation who are currently treated with anti-coagulation drug therapy or an anti-platelet therapyOn Warfarin during the past 6 months who have received at least one PT test over the last three months.
Warfarin prescribed for nonvalvular AF or atrial Monthly INR for patients with nonvalvular AF or Table XX – ACE/ARB Therapy
High Risk
Hispanic
moderately or severely depressed LV systolic function) treated with an ACE inhibitor or ARB.
Patients with 1) Coronary Artery Disease (CAD) AND 2) diabetes and/or LVEF <40% who were Table XX – Screening
High Risk
Hispanic
CABG during measurement year with at least one LDL cholesterol test or all component cholesterol test.
CAD: one lipid profile (or ALL component tests) Table XX – Heart Failure Assessment
High Risk
Hispanic
Documentation of quantitative or qualitative LVF Assessment. (Refer to ICD-9 codes for HF) Newly diagnosed who are beginning medical treatment should receive an evaluation of their left ventricular ejection fraction (LVEF) within 1 month of the start of treatmentInitial laboratory testing complete blood count, urinalysis, serum electrolytes, (including calcium and magnesium), blood urea nitrogen, serum creatinine, blood glucose, liver function tests, thyroid-stimulating hormone Table XX – Compliance with Follow-up/ Transition of Care
High Risk
Hispanic
CABG: Follow-up after hospitalization with any outpatient provider within 1-7 days after discharge CABG: Follow-up after hospitalization with any outpatient provider within 8-14 days after dischargeCABG: Follow-up after hospitalization with any outpatient provider within 15-21 days after dischargeCABG: Follow-up after hospitalization with any outpatient provider within 22-28 days after dischargeCABG: Follow-up after hospitalization with a cardiologist within 1-7 days after dischargeCABG: Follow-up after hospitalization with a cardiologist within 8-14 days after dischargeCABG: Follow-up after hospitalization with a cardiologist within 15-21 days after dischargeCABG: Follow-up after hospitalization with a cardiologist within 22-28 days after dischargeCABG: Follow-up after hospitalization with cardio-thoracic surgeon within 1-7 days after dischargeCABG: Follow-up after hospitalization with cardio-thoracic surgeon within 8-14 days after dischargeCABG: Follow-up after hospitalization with cardio-thoracic surgeon within 15-21 days after dischargeCABG: Follow-up after hospitalization with cardio-thoracic surgeon within 22-28 days after dischargeCABG: Follow-up after hospitalization with PCP within 1-7 days after dischargeCABG: Follow-up after hospitalization with PCP within 8-14 days after dischargeCABG: Follow-up after hospitalization with PCP within 15-21 days after dischargeCABG: Follow-up after hospitalization with PCP within 22-28 days after dischargePercentage of patients, regardless of age, discharged from an inpatient facility to ambulatory care, who were scheduled by the discharge facility for a follow-up appointment (HF principle diagnosis) Note: The claims data contain a provider code that identifies the facility or physician (or other professional) who is submitting the claim so it would be possible to determine whether a particular provider was a cardiologist, cardiac surgeon, or PCP, but we don't have the key to those provider codes.
Table XX - Hospital Readmissions & ER Visits
High Risk
Hispanic
Same Hospital Readmission Rate for cardiac condition within 1-30 days after discharge Same Hospital Readmission Rate for cardiac condition within 31-60 days after dischargeSame Hospital Readmission Rate for cardiac condition within 61-90 days after dischargeSame Hospital Readmission Rate for cardiac condition within 91-120 days after discharge Same Hospital Readmission Rate for cardiac condition within 121-180 days after dischargeSame Hospital Readmission Rate for cardiac condition within 181-360 days after dischargeSame Hospital Readmission Rate for non-cardiac condition within 1-30 days after dischargeSame Hospital Readmission Rate for non-cardiac condition within 31-60 days after discharge Same Hospital Readmission Rate for non-cardiac condition within 61-90 days after dischargeSame Hospital Readmission Rate for non-cardiac condition within 91-120 days after dischargeSame Hospital Readmission Rate for non-cardiac condition within 121-180 days after discharge Same Hospital Readmission Rate for non-cardiac condition within 181-360 days after dischargeReadmission Rate to a different hospital for cardiac condition within 1-30 days after dischargeReadmission Rate to a different hospital for cardiac condition within 31-60 days after dischargeReadmission Rate to a different hospital for cardiac condition within 61-90 days after dischargeReadmission Rate to a different hospital for cardiac condition within 91-120 days after dischargeReadmission Rate to a different hospital for cardiac condition within 121-180 days after dischargeReadmission Rate to a different hospital for cardiac condition within 181-360 days after dischargeReadmission Rate to a different hospital for non- cardiac condition within 1-30 days after dischargeReadmission Rate to a different hospital for non- cardiac condition within 31-60 days after dischargeReadmission Rate to a different hospital for non- cardiac condition within 61-90 days after dischargeReadmission Rate to a different hospital for non- cardiac condition within 91-120 days after discharge Readmission Rate to a different hospital for non- cardiac condition within 121-180 days after dischargeReadmission Rate to a different hospital for non- cardiac condition within 181-360 days after dischargeER Visit to same hospital for cardiac condition 1- ER Visit to same hospital for cardiac condition 31- 16 ER Visit to same hospital for non-cardiac ER Visit to same hospital for non-cardiac ER Visit to different hospital for cardiac condition 14 ER Visit to different hospital for cardiac condition 6 31-60 days after dischargeER Visit to different hospital for non-cardiac ER Visit to different hospital for non-cardiac Table XX – Mortality Rate
High Risk
Hispanic
Mortality rate: within 1-30 days of procedure if discharged, or if during hospitalization (where procedure was performed)Mortality rate: within 31-60 days of procedure if discharged, or if during hospitalization (where procedure was performed)Mortality rate: within 61-90 days of procedure if discharged, or if during hospitalization (where procedure was performed)Mortality rate: within 91-120 days of procedure if discharged, or if during hospitalization (where procedure was performed)Mortality rate: within 121-180 days of procedure if discharged, or if during hospitalization (where procedure was performed)Mortality rate: within 181-360 days of procedure if discharged, or if during hospitalization (where procedure was performed)Premature deaths from circulatory disease: progress against a target (i.e. <75 years old) Table XX – Other
High Risk
Hispanic
Coronary artery bypass graft (CABG) using Surgical Volume: Isolated Coronary Artery 1) Thrombolytic Treatment: a. Within 30 minutes of arrival of hospital; b. Within 60 minutes of calling for professional help c. Pre-hospital pre-thrombolytic treatment 2) Primary Angioplasty (post-MI); 3) Use of secondary prevention Age-based disparities in coronary heart disease treatment.

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