0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Commentary |

Sex Differences in Hospital Risk-Adjusted Mortality Rates for Medicare Beneficiaries Undergoing CABG Surgery—Invited Commentary

Adrian F. Hernandez, MD, MHS; Sean M. O'Brien, PhD
Arch Intern Med. 2008;168(21):2323-2325. doi:10.1001/archinternmed.2008.516.
Text Size: A A A
Published online

Extract

Since the first hospital-specific performance reporting for CABG surgery over 20 years ago, continuous quality improvement has led to a steady and incremental decline in CABG mortality rates.1,2 This decline has occurred in the face of changing patient characteristics plus increased use of percutaneous procedures making the risk profile of surgical patients significantly higher than in prior decades.1 Reasons for improvement in reported outcomes are multifactorial and include significant attention to process of care coupled with improvements in cardiac surgery techniques. However, other potential reasons for improved reported outcomes may reflect differences in reporting rather than actual outcomes: patients might be shifted to other reporting categories, or lower-risk patients may be treated in higher-quality hospitals. While some researchers question whether reporting of outcomes has caused a true improvement in CABG outcomes or simply an improvement in reporting, significant evidence indicates that reporting performance measures effectively motivates physicians to improve their care.3 But the question always remains: “How can outcomes improve even more?”

Figures in this Article

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Place holder to copy figure label and caption
Figure.

Changes in performance tiers from 2006 to 2007 for risk-adjusted mortality rates (RAMR) of patients 65 years or older undergoing isolated coronary artery bypass graft (data from the Society of Thoracic Surgeons' National Cardiovascular Database14). A, Classification of 2006 tier 1 (best) hospitals by RAMR in 2007. B, Classification of 2006 tier 4 (worst) hospitals by RAMR in 2007.

Graphic Jump Location

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com
brightcove.createExperiences();