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Coronary angioplasty volume-outcome relationships for hospitals and cardiologists

E L Hannan1, M Racz, T J Ryan

  • 1State University of New York at Albany, 12144-3456, USA.

JAMA
|March 19, 1997
PubMed

Insights

Higher hospital and cardiologist volume for percutaneous transluminal coronary angioplasty (PTCA) is linked to better patient outcomes. Increased procedural volume is associated with lower in-hospital mortality and coronary artery bypass graft surgery rates.

Area of Science:

  • Cardiovascular Medicine
  • Health Services Research
  • Interventional Cardiology

Background:

  • Provider volume is a critical factor in healthcare quality.
  • Assessing the impact of hospital and cardiologist procedural volume on patient outcomes is essential for quality improvement.

Purpose of the Study:

  • To evaluate the association between annual hospital and cardiologist volume for percutaneous transluminal coronary angioplasty (PTCA).
  • To determine the relationship between PTCA volume and in-hospital mortality and same-stay coronary artery bypass graft (CABG) surgery rates.

Main Methods:

  • A cohort study utilizing data from the New York State Department of Health's Coronary Angioplasty Reporting System (1991-1994).
  • Included 62,670 patients undergoing PTCA across 31 hospitals in New York State.
  • Analyzed in-hospital mortality and same-stay CABG surgery rates as primary outcomes.

Main Results:

  • Overall in-hospital mortality was 0.90% and same-stay CABG rate was 3.43%.
  • Lower hospital PTCA volume (<600) was associated with significantly higher mortality (0.96%) and CABG rates (3.92%).
  • Lower cardiologist PTCA volume (<75) also showed significantly higher mortality (1.03%) and CABG rates (3.93%).

Conclusions:

  • Both hospital and cardiologist PTCA volume are significantly inversely related to in-hospital mortality and same-stay CABG surgery rates.
  • Higher procedural volumes for PTCA are associated with improved patient safety and outcomes.
  • Findings support the importance of volume-outcome relationships in interventional cardiology.
Abstract

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