The effects of New York’s bypass surgery provider profiling on access to care and patient outcomes in the elderly
Eric D. Peterson, MD, MPH*  ,
Elizabeth R. DeLong, PhD*  ,
James G. Jollis, MD, FACC* ,
Lawrence H. Muhlbaier, PhD* and
Daniel B. Mark, MD, MPH, FACC*
* Outcomes Research and Assessment Group, Duke Clinical Research Institute, Durham, North Carolina, USA
Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
Division of Biometry, Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina, USA
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Figure 1 Yearly trends in the percentage of NY residents receiving bypass surgery at hospitals outside NY state between 1987 and 1992.
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Figure 2 Rates of in-hospital bypass surgery following myocardial infarction among patients aged 65 to 70 years (boxes) and 75 to 80 years (triangles) in NY (solid lines) and U.S. non-NY hospitals (dotted lines).
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Figure 3 Yearly trends in 30-day mortality rates following bypass surgery in NY (squares) vs. U.S. non-NY hospitals (diamonds).
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Figure 4 Individual states’ 1992 adjusted bypass surgery 30-day mortality rate (controlling for age, gender, race, acute MI admission and comorbidity) vs. their adjusted average yearly decline in bypass surgery mortality risk between 1987 and 1992. The crosslines indicate national averages. Note: NNE refers to the northern New England region (Maine, New Hampshire and Vermont) which share a provider profiling program. LoVol refers to a composite of 10 states performing 500 or less bypass surgeries per year (including Alaska, Wyoming, Delaware, Idaho, New Mexico, Hawaii, Rhode Island, Montana and North and South Dakota).
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