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1994 Coronary Bypass Report

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1994 Coronary Bypass Report Powered By Docstoc
					               CORONARY BYPASS SURGERY
                   IN ILLINOIS: 1994



                     DECEMBER 1995




MS. JOHANNA LUND, CHAIR    MR. LARRY LAWLER, VICE CHAIR

      DR. JOSEPH A. BONEFESTE, EXECUTIVE DIRECTOR
The Illinois Health Care Cost Containment Council (IHCCCC) was established in 1984 by the Illinois
General Assembly and directed to create a uniform system for the collection, analysis, and distribution
of health care cost and utilization data. The Council consists of eleven members representing the
following constituencies: consumers (3), insurance companies (2), providers (3), and businesses (3).
The members are appointed by the Governor for three year terms.

The IHCCCC serves as a resource agency dedicated to assisting regulators, legislators, consumers,
providers and purchasers of health care and other state agencies concerned with health care with
information vital to the: (1) stabilization or reduction of the cost of health care, (2) provision of
access to adequate health care, and (3) maintenance and/or improvement of the quality of care
provided by the health care system.

This report summarizes the characteristics of coronary bypass surgeries performed in Illinois hospitals
during calendar year 1994. The data were analyzed and interpreted by IHCCCC staff and this report
was authored by Amy McCombs, Research Associate.

Questions or comments concerning this report should be addressed to the address or phone number
listed below.


                        The Illinois Health Care Cost Containment Council
                                   4500 South Sixth Street Road
                                              Suite 215
                                     Springfield, IL 62703-5118
                                          (217) 786-7001
                                                    TABLE OF CONTENTS


Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Introduction

According to the American Heart Association (1995), about one in four Americans has one or more
forms of cardiovascular disease (high blood pressure, coronary heart disease, stroke, or rheumatic
heart disease). Heart disease is a major cause of hospitalization in Illinois. In fact, heart and
circulatory diseases account for three of the top ten most frequent reasons for hospitalization, besides
childbirth, in Illinois. A common treatment for many of these cases is coronary artery bypass surgery,
a procedure in which grafts are constructed to divert blood flow around blockages in the coronary
arteries.

This procedure is necessary when an artery is substantially narrowed or closed, either by a buildup
of plaque or by a blood clot that lodges in the narrowed area. Surgeons bypass these blockages by
taking small segments of vein usually from the leg or chest cavity and reattaching them to the aorta
and heart muscle. This bypass re-establishes the flow of blood to the heart muscle. Sometimes, more
than one bypass is needed, depending on where the blockage occurs and how many blockages exist.
Triple, quadruple and quintuple bypasses mean the surgeon has created several new pathways for the
blood supply to the heart.

There are several risk factors for coronary heart disease. Some of the most notable are: current
cigarette smoking, physical inactivity, being overweight, having high blood pressure, having high
blood cholesterol, and having diabetes. Some studies claim that being male is a risk factor, because
of the much higher percentage of men being treated with coronary bypass surgery. Others claim that
women are undertreated. However, a few recent studies suggest that men are actually being
overtreated for coronary heart disease (Agency for Health Care Policy Research, 1995).

This report presents current statistics on the frequency, average charges and average length of stay
(ALOS) for coronary bypass procedures performed at Illinois hospitals during 1994. Also included
are comparisons to data from previous years.

Data

The data source for this study was the 1994 Illinois Uniform Billing Form (UB-92) database. Data
are maintained in computerized files by the Illinois Health Care Cost Containment Council
(IHCCCC). The UB-92 database includes nearly 1.6 million discharges per year among Illinois' 229
hospitals. This total represents over 98 percent of all discharges from Illinois hospitals during 1994.

Coronary bypass cases were identified based upon the Diagnosis Related Group (DRG) classification
of each discharge. Two DRGs were included in this study, 106 and 107. DRG 106 includes all cases
of coronary bypass with cardiac catheterization and DRG 107 includes all cases of coronary bypass
without cardiac catheterization.




                                                   1
Data Considerations
The IHCCCC data used in this report is based on charges, rather than payments. These data reflect
hospital facility charges only. They do not include physician or surgeon fees. Also, because these
data are charge data, they may not reflect the actual payment received by the hospital. For example,
some payers have discounted payment arrangements with hospitals and do not pay on an actual
charge basis. Such is the case with alternative delivery systems in Illinois such as HMOs and PPOs.
Additionally, Medicare and Medicaid use separate health care reimbursement methods. Although
charges are usually more than actual payments, they serve as a reasonable and consistent basis for
comparison across hospitals and Health Service Areas, as well as over time.

Finally, the data in this report are not adjusted for any differences across hospitals in the severity of
illness of the patients treated. The data reflect the actual charges and lengths of stay reported to
IHCCCC and no attempt has been made to severity adjust the data.

Results

There are 229 hospitals in Illinois, of which 56 (24.5 percent), performed coronary bypass procedures
during 1994 -- only one hospital more than in 1993. This represents a significant change since 1989,
when there were 234 hospitals in Illinois and only 41 (18 percent), of them performed coronary
bypass procedures. The total number of coronary bypass surgeries in Illinois reported during 1994
was 11,719, an 8 percent increase over the previous year's total (10,879 procedures in 1993). Since
1989, the total number of coronary bypass procedures reported in Illinois has risen 72 percent (6,802
procedures in 1989).

The average charge for a coronary bypass procedure in 1989 was $36,485. This average charge had
increased 36 percent to $49,650 by 1993. By 1994, the average charge increased to $49,699. This
represents a 14.6 percent real (inflation-adjusted) increase1 since 1989. Total hospital charges for all
coronary bypass surgeries in the State during 1994 were approximately $582,000,000 -- more than
double the charges for 1989 (approximately $250,000,000).

Although the number of procedures and the average charge for those procedures both increased
between 1989 and 1994, the average length of stay (ALOS) decreased during that same time period.
In 1989, the ALOS was 14.1 days. This number decreased to 11.2 days by 1993 and 10.4 days in
1994, representing a 26 percent decrease from 1989 to 1994. In 1994, patients who had cardiac
catheterization performed during the same hospitalization as their coronary bypass surgery averaged



        1
         The inflation-adjusted average charge measures the extent to which the average charge has
increased more rapidly than the overall inflation rate. This figure was calculated by: (a) dividing the
ratio of 1994 to 1989 charges by the ratio of 1994 to 1989 consumer price index values, (b)
subtracting one, and (c) multiplying the resulting figure by 100%. During this period, the consumer
price index (for all items and all urban consumers) increased by 18.7% from 126.1 to 149.7 (Bureau
of Labor Statistics, 1995).

                                                   2
2.1 days longer in the hospital than patients who did not undergo cardiac catheterization at the time
of the surgery (11.1 days versus 9.0 days).

Although almost two-thirds (60 percent) of all coronary bypass procedures throughout the State are
performed in Chicago-area hospitals (HSA's VI and VII--Cook and DuPage Counties), the hospital
with the most coronary bypass procedures reported in 1994 was St. John's Hospital in Springfield,
with 1,138 procedures. The next highest number of procedures performed by a single hospital was
721, by F. G. McGaw/Loyola University in Maywood, followed by Memorial Medical Center in
Springfield with 510 procedures.

Coronary Bypass With and Without Cardiac Catheterization
Coronary bypass surgery can be performed with or without cardiac catheterization occurring at the
time of surgery. In 1994, there were more procedures performed with cardiac catheterization (7,723)
than without (3,996). Compared to the numbers of procedures in 1993, these numbers represent a
15 percent increase in procedures performed with cardiac catheterization, and a 4 percent decrease
in procedures performed without cardiac catheterization. When compared with the 1989 figures of
3,300 (with cardiac catheterization) and 3,502 (without cardiac catheterization), however, both
numbers represent increases (134 percent and 14 percent, respectively).

Not only were there more coronary bypass procedures performed with cardiac catheterization, but
the average charge for this procedure was 18 percent higher ($52,396 versus $44,485), and the
ALOS was 23 percent higher. Table 1 below provides the data on the number of discharges, ALOS
and average charge for each DRG and for all coronary bypass procedures.


            TABLE 1: Frequency, ALOS and Average Charges for Coronary
            Bypass Surgery by DRG for 1994

                                           DRG 106         DRG 107
                                          With Cardiac    w/o Cardiac          1994
                                         Catheterization Catheterization      TOTAL

            No. of Discharges                      7,723            3,996      11,719
            Average Length of Stay                  11.1                9        10.4
            Average Charge                       $52,397          $44,485     $49,699




Differences Across Health Service Areas
Health Service Areas (HSAs) are areas of the state designated by the federal government for health
planning purposes. There are 11 HSAs in Illinois and a map outlining them is included as Figure 3
in this report. As in previous years, a wide variation in average hospital charges exists across HSAs.

                                                  3
For example, the average charge for hospitals in the city of Chicago (HSA VI) is $69,727 with
cardiac catheterization and $61,914 without cardiac catheterization. For hospitals in West Central
Illinois (HSA III), the average charge is approximately half, at $35,450 with cardiac catheterization
and $30,241 without cardiac catheterization (see Figure 1). There may be many reasons for these
differences in charges. They may be the result of differences across hospitals in the severity of illness
of cardiac patients, lengths of stay, the cost of operating open heart surgical programs, or overall
pricing strategies.

There was also variation across Health Service Areas in average lengths of stay (ALOS). For
procedures with cardiac catheterization, the ALOS ranged from 9.3 days in HSA III (West Central)
to 14.1 days in HSA XI (East St. Louis, Belleville, Alton). For procedures without cardiac
catheterization, the ALOS ranged from 7.9 days in HSA VIII (McHenry, Lake & Kane Counties) to
13.9 days in HSA XI (East St. Louis, Belleville, Alton).

Male-Female Differences
Statewide, there were differences between males and females in the number of surgeries, the average
length of stay (ALOS) and average charges. Among all age groups, females accounted for 30.3%
of all coronary bypass surgeries in 1994 (3,546 among females, 8,173 among males). This percentage
represents only a slight increase since 1989, when females accounted for 28% of all coronary bypass
surgeries. The 1994 ALOS for females was 1.9 days longer than it was for males (11.7 days for
females, 9.8 days for males). The difference in ALOS has decreased since 1989, when the ALOS for
females was 2.9 days longer than for males (16.2 days for females, 13.3 days for males).

The average charges were also higher for females in both 1994 and 1989. In 1994, the average
charge for females was $5,619 (11.7%) higher than for males ($53,618 for females, $47,999 for
males). This difference is more than the difference in 1993, when the average charge for females was
$5,186 (10.8%) higher than for males ($53,269 for females, $48,083 for males), although both years
show less of a difference than in 1989, when the average charge for females was $7,091 (20.5%)
higher ($41,622 for females, $34,531 for males).

Although the average charge was higher for females, the average charge per day was 6.5% higher for
males, $298 per day, in 1994 ($4,585 per day for females, $4,883 per day for males). In 1993, the
average charge per day was 5.6 percent ($237 per day) higher for males than females. This difference
was even smaller in 1989, when the average charge per day was only $25 per day (1.0%) higher for
males than for females ($2,568 per day for females, $2,593 per day for males).

Some of the largest male-female differences occurred among those aged 45-64, an age group that
accounted for 40% (4,690) of all coronary bypass surgeries in 1994. For this age group, the average
length of stay was 1.8 days longer for females than males (10.5 days for females, 8.7 days for males)
and the average charge was $5,217 higher for females than males ($50,413 for females, $45,197 for
males). In this age group, males accounted for 76% of all coronary bypass surgeries performed
during 1994.



                                                   4
The table below provides frequency, ALOS, and average charges by gender and age group for all
coronary bypass procedures in Illinois during 1994.


         TABLE 2: Frequency, ALOS and Average Charges by Gender
                  for All Coronary Bypass Surgeries, 1994
                               FEMALES                                             MALES

Age        No. of     ALOS           Average        Average    No. of     ALOS           Average        Average
Groups     Discharges (Days)         Charge         Charge per Discharges (Days)         Charge         Charge per
                                                    Day                                                 Day

1-14                **          **             **           **         **           **             **           **

15-24               **          **             **           **         **           **             **           **

25-44              101          9.8 $46,942.76       $4,796.86        325           8.3 $43,663.60       $5,277.30

45-64            1104          10.5 $50,413.17       $4,784.91       3586           8.7 $45,196.51       $5,167.14

65+              2340          12.3 $55,414.68       $4,494.76       4260          10.9 $50,688.39       $4,647.61

Total            3546          11.7 $53,618.11       $4,585.52       8173           9.8 $47,999.19       $4,883.26
** Note: Data are not shown for those age groups with less than 5 coronary bypass surgeries
reported in 1994, although all data are included in the totals.


Discussion

Cardiovascular diseases in the United States are common and costly. The American Heart
Association estimated the cost of all major cardiovascular diseases in 1995 to be $137.7 billion. This
estimate includes the cost of physician and nursing services, hospital and nursing home services, the
cost of medications and lost productivity resulting from disability (AHA, 1995). During the past
several years, Illinois has seen a dramatic increase in the number of coronary bypass surgeries being
performed. The average hospital charges for these procedures have also increased, at a rate greater
than that of general inflation. Although there have been increases in the frequency and the average
charges for these procedures, the average length of stay has decreased. According to information
provided by the Illinois Hospital & HealthSystems Association, this decrease is due in part to pre-
surgical diagnostic testing conducted outside of hospital settings. Follow-up home care and recovery
services have also contributed to the reduction in length of stay.

There may be a relationship between successful surgery and the frequency of surgical procedures
within a particular hospital or by surgeons and/or surgical teams. A recent study of coronary bypass
procedure mortality rates in Colorado hospitals found that hospitals that perform more coronary
bypass procedures report fewer patient deaths. Hospitals that performed more than 200 bypasses
annually posted an average mortality rate of 2.1 percent, while hospitals that performed less than 200

                                                        5
surgeries each year had a 3.6 percent average mortality rate (Scott, 1995). In another study,
researchers attributed part of the dramatic decline (41 percent) in deaths following coronary bypass
surgery in New York State between 1989 and 1992 to fewer surgeries being performed by low-
volume surgeons (50 or less per year). (Hannan, Siu, Kumar, and others, 1995).


Tables and Figures

Table 3 contains a listing of the 56 Illinois hospitals that performed coronary bypass surgeries in
1994, indicating the number of discharges by hospital, average charge per discharge, and average
length of stay. The data are presented in alphabetical order by hospital name within HSA. Table 4
reports the same information in alphabetical order by hospital name for the entire State, with the data
separated by DRGs 106 and 107.

Figures 1 & 2 are also included in this report. These figures display average charge and average
length of stay information for coronary bypass procedures by HSA throughout the State. An HSA
map is included as Figure 3.



                                             References

Agency for Health Care Policy and Research. (March/April, 1995). Physicians may overestimate
      being male as a cardiac risk factor. Research Activities, 183, 8-10.

American Heart Association. (February, 1995). Heart and Stroke Facts: 1995 Statistical
      Supplement.

Bureau of Labor Statistics (July, 1995). Personal communication.

Hannan, E.L., Siu, A.L., Kumar, D., and others. (1995). Journal of American Medical Association,
273 (3), 209-213.

Scott, Lisa. (June, 1995). Colorado data will add to debate on number of heart programs. Modern
        Healthcare, 25(3), 32-33.




                                                  6
                                                     TABLE 3
                                  Average Total Charges and Average Length of Stay
                                       for Coronary Bypass Procedures in 1994

                                                               DRG 106                      DRG 107
                                                               with Cardiac Catheterization without Cardiac Catheterization
                                                                    No. of      Avg.              No. of         Avg.
Name                                       City                Discharges     Charge ALOS Discharges          Charge ALOS

HSA I
Rockford Memorial Hospital¹                Rockford                   159       $42,861.00        10.5             47          $34,888.00           8.4
St. Anthony Hospital Med. Ctr.¹            Rockford                   197       $37,516.00        11.5             75          $30,020.00           9.6
Swedish American Hospital                  Rockford                   120       $53,322.00        11.6             55          $41,015.00           7.9
HSA II
Methodist Medical Center                   Peoria                     156       $47,247.00        10               56          $38,908.00           8
Proctor Hospital                           Peoria                      63       $49,775.00        12               19          $43,086.00          11.5
St. Francis Medical Center¹                Peoria                     259       $37,594.00        10.4            146          $27,027.00           7.7
HSA III
Memorial Medical Center                    Springfield                398       $36,947.00         9.3            112          $31,979.00           8.9
St. John's Hospital                        Springfield                940       $34,816.00         9.3            198          $29,257.00           8.1
HSA IV
Carle Foundation Hospital¹                 Urbana                     282       $43,096.00        11.1             62          $52,016.00          13.6
Covenant Med Ctr-Urbana Campus             Urbana                     104       $64,137.00        12               88          $42,772.00           7.3
St. Joseph's Hosp. Med. Ctr.               Bloomington                142       $56,156.00        11.2            113          $41,019.00           8
HSA VI
Children's Memorial Hospital¹              Chicago                      *             *            *                *                *              *
Columbus Hospital                          Chicago                     41       $74,269.00        13.4             22          $50,323.00           7.4
Cook County Hospital¹                      Chicago                     32       $25,299.00        16.3             34          $20,937.00          15.8
Edgewater Medical Center                   Chicago                     10      $127,378.00        20                3          $78,418.00          11.3
Grant Hospital of Chicago                  Chicago                     53       $71,146.00        13.5             19          $66,296.00          11.3
Illinois Masonic Medical Ctr.¹ **          Chicago                     62      $118,557.00        14.1             93         $126,876.00          14.2
Louis A. Weiss Memorial Hosp. **           Chicago                     19       $75,025.00        15.3             29          $72,729.00          15.4
Mercy Hospital & Medical Ctr.              Chicago                     41       $55,843.00        11.7             28          $43,438.00           8.3
Michael Reese Hosp. and Medical Ctr.       Chicago                     88       $87,420.00        13.3             83          $68,957.00           9.2
Mt. Sinai Hospital Medical Ctr.¹ **        Chicago                      5       $64,091.00        13.8              7          $42,627.00           7.6
Northwestern Memorial Hospital¹            Chicago                    140       $60,797.00        12.6            136          $45,920.00           9.1
Ravenswood Hosp./Medical Ctr.              Chicago                     19       $71,457.00        15.9             27          $54,913.00          11.4
Resurrection Hospital                      Chicago                    138       $63,081.00        13.2             40          $47,320.00          10.7
Rush-Presby-St. Lukes Med. Ctr.            Chicago                     75       $56,951.00        10.4             69          $49,037.00           8.8
St. Joseph Hospital **                     Chicago                     84       $60,737.00        11.3             33          $44,564.00           7.9
St. Mary of Nazareth Hosp. Ctr.            Chicago                     41       $84,505.00        18.2             29          $67,863.00          12.1
Univ. of Chicago Hsps & Clinics¹           Chicago                     63       $73,418.00        10.7             93          $57,834.00           8.1
University of Illinois                     Chicago                     52       $60,369.00        16               41          $58,106.00          11.4
HSA VII
Alexian Bros. Medical Center               Elk Grove Vill.            229       $53,745.00        10.3             57          $46,054.00           9
Central DuPage Hospital                    Winfield                   158       $56,866.00        10.2             37          $43,475.00           7.1
Christ Hospital¹ **                        Oak Lawn                   330       $49,032.00        11.4            172          $34,243.00           8
Edward Hospital Association                Naperville                  95       $49,132.00         8.4             72          $35,278.00           6.3

* Note: Data are presented only for those hospitals who performed 10 or more coronary bypass procedures during 1994.

Note: Guidelines established by Illinois Department of Public Health stipulate that hospitals which perform open heart surgeries are required to
perform a minimum of 200 adult open heart procedures or 100 pediatric open heart operations annually within three years after initiation of the
program.




                                                                          7
                                                   TABLE 3
                                Average Total Charges and Average Length of Stay
                                     for Coronary Bypass Procedures in 1994

                                                             DRG 106                      DRG 107
                                                             with Cardiac Catheterization without Cardiac Catheterization
                                                                  No. of      Avg.              No. of         Avg.
Name                                      City               Discharges     Charge ALOS Discharges          Charge ALOS



Elmhurst Memorial Hospital                Elmhurst                  169       $58,755.00       10.6         45   $47,398.00    7.9
Evanston Hospital                         Evanston                  144       $47,041.00       12.8        156   $30,330.00    7.6
F. G. McGaw/Loyola University1            Maywood                   331       $61,864.00       13.4        390   $47,208.00   10.1
GlenOaks Medical Center                   Glendale Hts.               *             *           *            *         *       *
Good Samaritan Hospital¹                  Downers Grove             281       $51,175.00        9.7        125   $39,498.00    8.1
Gottlieb Memorial Hospital                Melrose Park              113       $60,106.00       10.9         20   $45,261.00    7.6
Hinsdale Hospital                         Hinsdale                  151       $70,878.00       10.9         53   $59,579.00    9.6
Ingalls Memorial Hospital                 Harvey                    100       $60,645.00       12.3         92   $48,374.00    8.9
La Grange Memorial Hospial **             La Grange                 133       $53,810.00        7.8         37   $52,450.00    7.8
Lutheran General Hospital¹                Park Ridge                189       $37,729.00       12          130   $37,729.00    7.6
Northwest Community Hospital              Arlington Hts.            218       $51,085.00       12.3         81   $38,768.00    8.4
Olympia Fields Osteo. Med. Ctr.¹          Olympia Fields             34       $47,492.00        9.1         17   $51,781.00    9.6
Rush North Shore Medical Ctr. **          Skokie                     97       $76,235.00       13.9         35   $50,541.00    8.9
St. Francis Hospital                      Blue Island               215       $50,702.00       10.4        181   $38,907.00    7.8
St. Francis Hospital                      Evanston                  187       $47,311.00       12.7        214   $36,320.00   10.1
West Suburban Hospital                    Oak Park                   62       $63,211.00       12.3         28   $52,988.00    9.6
Westlake Community Hospital               Melrose Park               59       $79,569.00       15.3         17   $67,941.00   13.2
HSA VIII
Copley Memorial Hospital                  Aurora                     24       $67,876.00       12.1          4   $48,562.00    8.8
Mercy Center For Health Care              Aurora                     78       $53,254.00       12.1         24   $38,814.00    7.8
Sherman Hospital Association              Elgin                     174       $53,616.00       10.2        113   $43,916.00    7.9
HSA IX
St. Joseph Medical Center                 Joliet                    295       $63,726.00       11          124   $53,365.00    8.2
HSA XI
Memorial Hospital                         Belleville                 31       $60,526.00       16.5          9   $59,994.00   15.3
St. Elizabeth's Hospital                  Belleville                 42       $61,310.00       12.4          5   $52,920.00   11.2
Total                                                              7723       $52,396.00       11.1       3996   $44,485.00    9




** NOTE: The data provided for these hospitals may not be totally accurate due to program
     logic errors detected in their vendor IHCCCC data submission processing software.




           1
            Designates Level 1 Trauma Center as determined by the Illinois Department of Public Health.


                                                                       8
                                                  TABLE 4
                               Average Total Charges and Average Length of Stay
                                    for Coronary Bypass Procedures in 1994

                                                            DRG 106                      DRG 107
                                                            with Cardiac Catheterization without Cardiac Catheterization
                                                                 No. of      Avg.              No. of         Avg.
Name                                     City               Discharges     Charge ALOS Discharges          Charge ALOS

Alexian Bros. Medical Center             Elk Grove Vill.          229       $53,745.00      10.3             57         $46,054.00     9
Carle Foundation Hospital                Urbana                   282       $43,096.00      11.1             62         $52,016.00    13.6
Central DuPage Hospital                  Winfield                 158       $56,866.00      10.2             37         $43,475.00     7.1
Children's Memorial Hospital             Chicago                   *                  *      *                *                   *     *
Christ Hospital                          Oak Lawn                 330       $49,032.00      11.4            172         $34,243.00     8
Columbus Hospital                        Chicago                   41       $74,269.00      13.4             22         $50,323.00     7.4
Cook County Hospital                     Chicago                   32       $25,299.00      16.3             34         $20,937.00    15.8
Copley Memorial Hospital                 Aurora                    24       $67,876.00      12.1              4         $48,562.00     8.8
Covenant Med Ctr-Urbana Campus           Urbana                   104       $64,137.00      12               88         $42,772.00     7.3
Edgewater Medical Center                 Chicago                   10      $127,378.00      20                3         $78,418.00    11.3
Edward Hospital Association              Naperville                95       $49,132.00       8.4             72         $35,278.00     6.3
Elmhurst Memorial Hospital               Elmhurst                 169       $58,755.00      10.6             45         $47,398.00     7.9
Evanston Hospital                        Evanston                 144       $47,041.00      12.8            156         $30,330.00     7.6
F. G. McGaw/Loyola University            Maywood                  331       $61,864.00      13.4            390         $47,208.00    10.1
GlenOaks Medical Center                  Glendale Hts.             *                  *       *              *                    *    *
Good Samaritan Hospital                  Downers Grove            281       $51,175.00       9.7            125         $39,498.00     8.1
Gottlieb Memorial Hospital               Melrose Park             113       $60,106.00      10.9             20         $45,261.00     7.6
Grant Hospital of Chicago                Chicago                   53       $71,146.00      13.5             19         $66,296.00    11.3
Hinsdale Hospital                        Hinsdale                 151       $70,878.00      10.9             53         $59,579.00     9.6
Illinois Masonic Medical Ctr.            Chicago                   62      $118,557.00      14.1             93        $126,876.00    14.2
Ingalls Memorial Hospital                Harvey                   100       $60,645.00      12.3             92         $48,374.00     8.9
La Grange Memorial Hospital              La Grange                133       $53,810.00       7.8             37         $52,450.00     7.8
Louis A. Weiss Memorial Hosp.            Chicago                   19       $75,025.00      15.3             29         $72,729.00    15.4
Lutheran General Hospital                Park Ridge               189       $58,598.00      12              130         $37,729.00     7.6
Memorial Hospital                        Belleville                31       $60,526.00      16.5              9         $59,994.00    15.3
Memorial Medical Center                  Springfield              398       $36,947.00       9.3            112         $31,979.00     8.9
Mercy Center For Health Care             Aurora                    78       $53,254.00      12.1             24         $38,814.00     7.8
Mercy Hospital & Medical Ctr.            Chicago                   41       $55,843.00      11.7             28         $43,438.00     8.3
Methodist Medical Center                 Peoria                   156       $47,247.00      10               56         $38,908.00     8
Michael Reese Hosp and Med Ctr           Chicago                   88       $87,420.00      13.3             83         $68,957.00     9.2
Mt. Sinai Hospital Medical Ctr           Chicago                    5       $64,091.00      13.8              7         $42,627.00     7.6
Northwest Community Hospital             Arlington Hts.           218       $51,085.00      12.3             81         $38,768.00     8.4
Northwestern Memorial Hospital           Chicago                  140       $60,797.00      12.6            136         $45,920.00     9.1
Olympia Fields Osteo. Med.Ctr.           Olympia Fields            34       $47,492.00       9.1             17         $51,781.00     9.6
Proctor Hospital                         Peoria                    63       $49,775.00      12               19         $43,086.00    11.5
Ravenswood Hosp./Medical Ctr.            Chicago                   19       $71,457.00      15.9             27         $54,913.00    11.4
Resurrection Hospital                    Chicago                  138       $63,081.00      13.2             40         $47,320.00    10.7
Rockford Memorial Hospital               Rockford                 159       $42,861.00      10.5             47         $34,888.00     8.4
Rush North Shore Medical Ctr.            Skokie                    97       $76,235.00      13.9             35         $50,541.00     8.9
Rush-Presby.-St. Lukes Med Ctr           Chicago                   75       $56,951.00      10.4             69         $49,037.00     8.8


* NOTE: Data are presented only for those hospitals who performed 10 or more coronary bypass procedures during 1994.
Sherman Hospital Association             Elgin                     174      $53,616.00       10.2           113         $43,916.00     7.9


                                                                     9
                                                    TABLE 4
                                 Average Total Charges and Average Length of Stay
                                      for Coronary Bypass Procedures in 1994

                                                     DRG 106                      DRG 107
                                                     with Cardiac Catheterization without Cardiac Catheterization
                                                          No. of      Avg.              No. of         Avg.
Name                                  City           Discharges     Charge ALOS Discharges          Charge ALOS

St. Anthony Hospital Med. Ctr.        Rockford           197    $37,516.00   11.5       75      $30,020.00    9.6
St. Elizabeth's Hospital              Belleville          42    $61,310.00   12.4        5      $52,920.00   11.2
St. Francis Hospital                  Blue Island        215    $50,702.00   10.4      181      $38,907.00    7.8
St. Francis Hospital                  Evanston           187    $47,311.00   12.7      214      $36,320.00   10.1
St. Francis Medical Center            Peoria             259    $37,594.00   10.4      146      $27,027.00    7.7
St. John's Hospital                   Springfield        940    $34,816.00    9.3      198      $29,257.00    8.1
St. Joseph Hospital                   Chicago             84    $60,737.00   11.3       33      $44,564.00    7.9
St. Joseph Medical Center             Joliet             295    $63,726.00   11        124      $53,365.00    8.2
St. Joseph's Hosp. Med. Ctr.          Bloomington        142    $56,156.00   11.2      113      $41,019.00    8
St. Mary of Nazareth Hosp. Ctr        Chicago             41    $84,505.00   18.2       29      $67,863.00   12.1
SwedishAmerican Hospital              Rockford           120    $53,322.00   11.6       55      $41,015.00    7.9
Univ of Chicago Hsps & Clinics        Chicago             63    $73,418.00   10.7       93      $57,834.00    8.1
University of Illinois                Chicago             52    $60,369.00   16         41      $58,106.00   11.4
West Suburban Hospital                Oak Park            62    $63,211.00   12.3       28      $52,988.00    9.6
Westlake Community Hospital           Melrose Park        59    $79,569.00   15.3       17      $67,941.00   13.2

Total                                                   7723    $52,396.00   11.1     3996      $44,485.00    9




                                                           10
                                           Figure 1: Average Charges
                                        by HSA and DRG in Illinois, 1994
70000
                                                        69727


                                                                                             63727
60000                                                       61914
                                                                                                         60978
                                                                                                             57468
                                                                     55843
                                                                                 54755
                                                                                                 53365
                                                                                                                     52397
50000                                       50753


                                                44199                                                                    44485
        43287                                                                        43180
                    42350                                                41581
40000

            34730               35450

30000                   31419
                                    30241




20000



10000



   0
         HSA 1      HSA 2       HSA 3        HSA 4      HSA 6        HSA 7        HSA 8       HSA 9      HSA 11       Total
                                                          DRG 106
                                                          DRG 107


                                                                11
                                           Figure 2: Average Length of Stay
                                           by HSA and DRG in Illinois, 1994
16


14                                                                                                             14.1 13.9

                                                           13.2

12
     11.2                                     11.3                        11.3                                             11.1
                                                                                       10.9         11
                  10.5                                            10.4
10
                               9.3                   9.1
            8.8                                                                                                                   9
                                                                                 8.7
 8                                   8.4                                                                 8.2
                         8.1                                                                  7.9


 6


 4


 2


 0
     HSA 1        HSA 2        HSA 3          HSA 4        HSA 6          HSA 7        HSA 8        HSA 9      HSA 11       Total
                                                                  DRG 106
                                                                  DRG 107


                                                                     12
                                  Figure 3
                           HEALTH SERVICE AREAS




Health Service Areas
 1 - Northwest (Rockford)
 2 - North Central (Peoria)
 3 - West Central (Springfield)
 4 - East Central (Bloomington,
         Champaign, Urbana, Decatur)
 5 - Southern
 6 - City of Chicago
 7 - Suburban Cook and DuPage
 8 - K-L-M (Kane, Lake and McHenry)
 9 - WKKG (Joliet, Kankakee)
10 - Quad Cities, Rock Island, Moline
11 - E. St. Louis, Belleville, Alton


                                        13

				
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