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TABLE OF CONTENTS

MESSAGE FROM COMMISSIONER DAINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DEPARTMENT OF HEALTH PROGRAM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PATIENT POPULATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . RISK ADJUSTMENT FOR ASSESSING PROVIDER PERFORMANCE . . . . . . . . . . . . . . . . . . . . .

.......... 1 .......... 3 .......... 3 .......... 3 .......... 4

Data Collection, Data Validation and Identifying In-Hospital/30-Day Deaths . . . . . . . . . . . . . . . . . . Assessing Patient Risk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Predicting Patient Mortality Rates for Providers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Computing the Risk-Adjusted Mortality Rate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Interpreting the Risk-Adjusted Mortality Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . How this Initiative Contributes to Quality Improvement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2008 HOSPITAL RISKADJUSTED MORTALITY FOR PCI . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

.......... 4 .......... 4 .......... 5 .......... 5 .......... 5 .......... 5 .......... 6

2006  2008 HOSPITAL DATA FOR PCI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

.......... 6

Table 1

In-Hospital/30-Day Observed, Expected and Risk-Adjusted Mortality Rates for PCI in New York State, 2008 Discharges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

.......... 8

Figure 1

In-Hospital/30-Day Risk-Adjusted Mortality Rates for PCI in New York State, 2008 Discharges (All Cases) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

.......... 9

Figure 2

In-Hospital/30-Day Risk-Adjusted Mortality Rates for PCI in New York State, 2008 Discharges (Non-Emergency Cases) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . 10

Table 2

In-Hospital/30-Day Observed and Risk-Adjusted Mortality Rates for PCI in New York State, 2006  2008 Discharges . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2006  2008 HOSPITAL AND CARDIOLOGIST DATA FOR PCI . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . 11 . . . . . . . . . 12

Table 3

Cardiologist In-Hospital/30-Day Observed, Expected and Risk-Adjusted Mortality Rates for PCI in New York State, 2006  2008 Discharges . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . 12

Table 4

Summary Information for Cardiologists Practicing at More an One Hospital, 2006  2008 Discharges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CRITERIA USED IN REPORTING SIGNIFICANT RISK FACTORS 2008 . . . . . . . . . . . . . . . . MEDICAL TERMINOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPENDIx 1 2008 Risk Factors for PCI In-Hospital/30-Day Mortality (All Cases) . . . . . . . . . . . . . . . APPENDIx 2 2008 Risk Factors For In-Hospital/30-Day Mortality for Non-Emergency PCI . . . . . . . APPENDIx 3 2006  2008 Risk Factors for PCI In-Hospital/30-Day Mortality (All Cases) . . . . . . . . . APPENDIx 4 2006  2008 Risk Factors for In-Hospital/30-Day Mortality for Non-Emergency PCI . . APPENDIx 5 2006  2008 Risk Factors for In-Hospital/30-Day Mortality for Emergency PCI . . . . . . NEW YORK STATE PERCUTANEOUS CORONARY INTERVENTION CENTERS . . . . . . . . . . .

. . . . . . . . . 28 . . . . . . . . . 44

. . . . . . . . . 45 . . . . . . . . . 46 . . . . . . . . . 48 . . . . . . . . . 49 . . . . . . . . . 51 . . . . . . . . . 52 . . . . . . . . . 53

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