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New report from PA Health Care Cost Containment Council profiles surgical outcomes at area hospitals
This week, a report issued by the Pennsylvania Health Care Cost Containment Council (PHC4) published outcome data for regional children’s hospitals that do pediatric heart surgery. This second publication is important in that it represents a trend toward transparency in reporting and is directed and available to the health care consumer.
Nemours/Alfred I. duPont Hospital for Children voluntarily participated in the report, allowing the Society for Thoracic Surgeons (STS) Congenital Database to share the hospital’s heart surgery statistics with the PHC4. Hospitals reported operative survival for 10 of the most common (benchmark) procedures with different levels of complexity, designated by the STS. The Nemours Cardiac Center at Alfred I. duPont Hospital for Children achieved excellent outcomes.
Nationally, Nemours performed comparably or exceeded survival rates for benchmark operations with zero mortality for many procedures, from simpler interventions such as coarctation of aorta repair and Glenn/Hemi-Fontan and Fontan procedures; to more complex forms of newborn surgery like Tetralogy of Fallot repair, the arterial switch operation and the Norwood procedure to manage hypoplastic left heart syndrome.
Pediatric cardiothoracic surgeon Christian Pizarro, MD, who directs the Nemours Cardiac Center, said: "The STS data provide the best benchmarks we currently have when looking at institutional performance and outcomes. However, much work remains to be done, to provide the appropriate risk adjustment to allow optimal interpretation of the data."
He noted that as more children survive surgery and its immediate aftermath, the focus is shifting toward long-term survival and quality of life. "Are children who have had heart surgery as infants hitting their developmental milestones one or two years later? How can changes in surgical technique improve outcomes years later, not just survival to discharge? Many questions remain to be answered," he continued, "and, like other institutions, we believe participation in multi-institutional registries are an important means to this end."
Many hospitals, including Nemours/duPont Hospital for Children, participate in voluntary reporting and make outcomes information available on their websites because the information is important to patients, families and practitioners. Cardiac surgery for adults and children continues to be at the forefront of surgical specialties in terms of both data collection and public reporting of outcomes. Dr. Pizarro noted, "It is inevitable that the trend toward public data-sharing will ramp up considerably as consumers expect better information on which to base their health care decisions." He added: "It is very reassuring that the quality of pediatric cardiac surgery is high, providing patients and families many options for finding excellent care within our region."