NEJM March 9, 2011
Dartmouth Atlas: Surgery rates for preference-sensitive conditions depends largely on where patients live and the clinicians they see.
Coronary artery bypass surgery (CABG) per 1,000 Medicare beneficiaries among hospital referral regions (2003-07)The colors on the map represent the rates of CABG surgery per 1,000 Medicare beneficiaries in each HRR. Rates are adjusted for age, sex and race. The highest rate, 8.9 procedures per 1,000 beneficiaries, was seen in McAllen, Texas. The lowest rate, 1.9 procedures per 1,000, was seen in Pueblo, Colorado. In other words, patients in the McAllen HRR were more than four times more likely than patients in the Pueblo HRR to undergo CABG during 2003-07. The national average rate of CABG was 4.6 per 1,000. The greatest variation within a single HRR was seen in Denver, where the rate of CABG surgery ranged from less than 2 per 1,000 beneficiaries in the Steamboat Springs, Colorado HSA to more than 7 per 1,000 in the McCook, Nebraska HSA.
Source: Improving Patient Decision-Making in Health Care: A 2011 Dartmouth Atlas Report Highlighting Minnesota
However, when the researchers analyzed certain groups of patients undergoing coronary artery interventions, they discovered that diabetic patients appeared to do much better following CABG, rather than PCI. Among the patients with diabetes, survival at 6 years after treatment was 30 percent greater among those diabetic patients who underwent CABG when compared to the diabetic patients who underwent PCI. CABG centers in Thailand
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