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CARDIAC CARE: 2015* VA AGGREGATE REPORTS

Totals by Payer



2015201420132012
2015

MortalityReadmission
 
Cardiology MedicalCardiology - Medical
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 this service line.
Payer Volume Used Actual Mortality Expected Mortality Percent of Cases Rating
Commercial 6,098 1.66% 1.39% 16.27%
Medicaid 2,191 1.51% 1.62% 5.85%
Medicare 26,290 2.02% 2.09% 70.16%
Other 634 1.89% 1.51% 1.69%
Self Pay/Charity 2,200 1.18% 1.12% 5.87%
Unknown 56 0.00% 0.31% 0.15%
Statewide Totals 37,469 1.88% 1.88% 100.00%


Invasive CardiologyCardiology - Invasive
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.
Payer Volume Used Actual Mortality Expected Mortality Percent of Cases Rating
Commercial 4,551 0.64% 0.86% 27.00%
Medicaid 802 1.12% 1.26% 4.76%
Medicare 9,752 1.23% 1.13% 57.87%
Other 439 0.91% 0.92% 2.60%
Self Pay/Charity 1,289 0.85% 0.77% 7.65%
Unknown 20 5.00% 1.12% 0.12%
Statewide Totals 16,853 1.03% 1.03% 100.00%


Open Heart SurgeryCardiology - Open Heart Surgery
Includes procedures such as coronary artery bypass surgery (CABG) and cardiac valve procedures.
Payer Volume Used Actual Mortality Expected Mortality Percent of Cases Rating
Commercial 1,596 0.63% 1.29% 34.70%
Medicaid 236 2.54% 2.39% 5.13%
Medicare 2,417 2.32% 1.93% 52.54%
Other 161 2.48% 1.66% 3.50%
Self Pay/Charity 186 1.61% 1.75% 4.04%
Unknown 4 0.00% 0.37% 0.09%
Statewide Totals 4,600 1.72% 1.72% 100.00%


Totals
Payer Volume Used Actual Mortality Expected Mortality Percent of Cases Rating
Commercial 12,245 1.14% 1.18% 20.78%
Medicaid 3,229 1.49% 1.59% 5.48%
Medicare 38,459 1.84% 1.83% 65.27%
Other 1,234 1.62% 1.32% 2.09%
Self Pay/Charity 3,675 1.09% 1.03% 6.24%
Unknown 80 1.25% 0.52% 0.14%
Statewide Totals 58,922 1.62% 1.62% 100.00%


* Please note that the 2015 Cardiac report includes only nine months of discharges. This shortened timeframe, from Jan 1 through Sept 30, 2015, is related to the replacement of the ICD-9 with the ICD-10 coding system effective with discharges on and after Oct 1, 2015. Because of the increased detail of the ICD-10 system, a number of APR-DRGs had significant differences in volume. While these differences are not errors, for comparability, VHI chose to include only the nine months of 2015 discharges before ICD-10 went into effect.

Total Patient Volume After Exclusions is the number of total patients in Virginia for a given service line(s) or demographic segment of a given service line(s) used in this comparison of actual to expected mortality in Virginia. This total does not include certain transferred or hospice care patients. The rationale and methodology for exclusions are explained in detail in the section titled "Methodology."

Volume Used is the number of total patients in Virginia for a given service line(s) or demographic segment of a given service line(s). This total does not include certain transferred or hospice care patients. The rationale and methodology for exclusions are explained in detail in the section titled "Methodology."

Comparison of Statewide Actual Mortality to Expected Mortality for a given service line(s) or demographic segment of a given service line(s) is determined using statistical significance which is calculated using volume, expected mortality and variance of mortality.

Statewide Actual Mortality Rate is the number of patients who died divided by the number of total patients for a given service line(s) or demographic segment of a given service line(s) in the state of Virginia.

Statewide Expected Mortality Rate for a given service line(s) or demographic segment of a given service line(s) is calculated based on the mix of patients within a hospital compared to similar patients treated in hospitals across Virginia.


Cardiology MedicalCardiology - Medical
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 this service line.
Payer Volume Used Actual Readmission Expected Readmission Percent of Cases Rating
Commercial 6,150 8.75% 11.20% 16.05%
Medicaid 2,215 17.43% 12.85% 5.78%
Medicare 27,082 13.77% 13.39% 70.67%
Other 633 10.11% 11.36% 1.65%
Self Pay/Charity 2,184 8.52% 10.59% 5.70%
Unknown 56 8.93% 10.19% 0.15%
Statewide Totals 38,320 12.81% 12.81% 100.00%


Invasive CardiologyCardiology - Invasive
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.
Payer Volume Used Actual Readmission Expected Readmission Percent of Cases Rating
Commercial 4,533 5.96% 8.16% 26.96%
Medicaid 807 11.28% 10.05% 4.80%
Medicare 9,735 10.80% 9.54% 57.90%
Other 435 6.67% 8.15% 2.59%
Self Pay/Charity 1,284 6.78% 8.66% 7.64%
Unknown 19 0.00% 8.14% 0.11%
Statewide Totals 16,813 9.09% 9.09% 100.00%


Open Heart SurgeryCardiology - Open Heart Surgery
Includes procedures such as coronary artery bypass surgery (CABG) and cardiac valve procedures.
Payer Volume Used Actual Readmission Expected Readmission Percent of Cases Rating
Commercial 1,586 5.17% 6.37% 35.08%
Medicaid 230 6.96% 6.58% 5.09%
Medicare 2,361 8.01% 7.12% 52.22%
Other 157 7.01% 6.99% 3.47%
Self Pay/Charity 183 5.46% 6.78% 4.05%
Unknown 4 0.00% 6.84% 0.09%
Statewide Totals 4,521 6.81% 6.81% 100.00%


Totals
Payer Volume Used Actual Readmission Expected Readmission Percent of Cases Rating
Commercial 12,269 7.25% 9.45% 20.57%
Medicaid 3,252 15.16% 11.72% 5.45%
Medicare 39,178 12.69% 12.06% 65.68%
Other 1,225 8.49% 9.66% 2.05%
Self Pay/Charity 3,651 7.75% 9.72% 6.12%
Unknown 79 6.33% 9.53% 0.13%
Statewide Totals 59,654 11.31% 11.31% 100.00%


Total Patient Volume After Exclusions is the number of total patients in Virginia for a given service line(s) or demographic segment of a given service line(s) used in this comparison of actual to expected mortality in Virginia. This total does not include certain transferred or hospice care patients. The rationale and methodology for exclusions are explained in detail in the section titled "Methodology."

Volume Used is the number of total patients in Virginia for a given service line(s) or demographic segment of a given service line(s). This total does not include certain transferred or hospice care patients. The rationale and methodology for exclusions are explained in detail in the section titled "Methodology."

Comparison of Statewide Actual Readmission to Expected Readmission for a given service line(s) or demographic segment of a given service line(s) is determined using Rating which is calculated using volume, expected Readmission and variance of Readmission.

Statewide Actual Readmission Rate is the number of all patients who were admitted to a hospital for a cardiac service line and subsequently readmitted within 30 days to a Virginia hospital for a service related to their prior discharge divided by the number of total patients for a given service line(s) or demographic segment of a given service line(s) in the state of Virginia.

Statewide Expected Readmission Rate for a given service line(s) or demographic segment of a given service line(s) is calculated based on the mix of patients within a hospital compared to similar patients treated in hospitals across Virginia.



Key to Symbols
- More than Expected
- As Expected
- Less than Expected
- Too Few to Calculate