Cardiac Care

There are many types of heart problems and ways to treat them.
VHI groups these different conditions and treatments into service lines to better compare care provided.

Medical Cardiology

includes diagnosing and therapy for heart disease. Angina, Congestive Heart Failure and Acute Myocardial Infarction (AMI) are all examples of heart conditions. When treatment for these conditions does not include surgery, VHI has grouped them into the MEDICAL CARDIOLOGY service line.

Invasive Cardiology

includes patients with medical conditions generally described in the medical cardiology service line that also had surgery. Surgeries include cardiac catheterization, cardiac pacemaker insertion, balloon angioplasty and placement of cardiac stents.

The version 34 3M APR-DRGs
used for each Service Line

190-ACUTE MYOCARDIAL INFARCTION
193-ACUTE & SUBACUTE ENDOCARDITIS
194-HEART FAILURE 1
196-CARDIAC ARREST
198-ANGINA PECTORIS & CORONARY ATHEROSCLEROSIS
199-HYPERTENSION
200-CARDIAC STRUCTURAL & VALVULAR DISORDERS
201-CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS
203-CHEST PAIN
205-CARDIOMYOPATHY
206-MALFUNCTION,REACTION & COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE
207-OTHER CIRCULATORY SYSTEM DIAGNOSES

161-CARDIAC DEFIBRILLATOR & HEART ASSIST IMPLANT
170-PERM CARDIAC PACEMAKER IMPL W AMI, HEART FAILURE OR SHOCK
171-PERM CARDIAC PACEMAKER IMPLANT W/O AMI, HEART FAILURE OR SHOCK
174-PERCUTANEOUS CARDIOVASCULAR PROCEDURES W AMI 2
175-PERCUTANEOUS CARDIOVASCULAR PROCEDURES W/O AMI 2
176-CARDIAC PACEMAKER & DEFIBRILLATOR DEVICE REPLACEMENT
177-CARDIAC PACEMAKER & DEFIB REVISION EXCEPT DEVICE REPLACEMENT
191-CARDIAC CATHETERIZATION W CIRC DISORDEXC ISCHEMIC HEART DISEASE 3
192-CARDIAC CATHETERIZATION FOR ISCHEMIC HEART DISEASE 3

160-MAJOR CARDIOTHORACIC REPAIR OFHEART ANOMALY
162-CARDIAC VALVE PROCEDURES W CARDIAC CATH
163-CARDIAC VALVE PROCEDURES W/O CARDIAC CATH
165-CORONARY BYPASS W/ CARDIAC CATH OR PERCUTANEOUS CARDIAC PROCEDURE 4
166-CORONARY BYPASS W/O CARDIAC CATH OR PERCUTANEOUS CARDIAC PROCEDURE 4

FOOTNOTE:
1APR-DRG 194 is also grouped under the sub-category "HEART FAILURE"
2APR-DRG 174 and APR-DRG 175 are also grouped under the sub-category "PERCUTANEOUS CARDIOVASCULAR PROCEDURES"
3APR-DRG 191 and APR-DRG 192 are also grouped under the sub-category "CARDIAC CATHERTIZATION"
4APR-DRG 165 and APR-DRG 166 are also grouped under the sub-category "CABG"

The All Patient Refined-Diagnosis Related Groups
were developed by 3M Health Information Systems.

Outcomes of care related to Hospital Death and 30-day Readmission Rates

VHI provides information on in-hospital deaths and death rates occurring during a cardiac care hospitalization. Lower death rates than what you would expect when comparing similar patients are better. VHI has excluded certain patients from this analysis including those receiving hospice care. The Methodology section provides more detail on what is excluded.

30-Day Readmission Rates are also provided. Readmission rates are important because they may reflect how complete care was during the hospital stay and whether the patient received or acted upon follow-up care during the first hospitalization.

VHI identifies whether patients are readmitted within thirty days of the original admission and calculates readmission rates. Not all readmissions are included--just those that appear to be related to the first admission. If someone was hospitalized for a medical cardiology problem and was readmitted two weeks later for medical cardiology, VHI would consider that related. If the same medical cardiology patient were readmitted after an automobile accident or for delivery of a baby, VHI would not consider that as a related readmission.

As with deaths, lower 30-day readmission rates than expected when comparing similarly ill patients are considered better. For outcome measures, VHI uses symbols to note whether death and readmission rates are less than expected, as expected, or higher than expected.