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While the two local hospitals that perform cardiac surgery generally had outcomes within expected ranges, Wilkes-Barre General did have higher-than-expected readmission rates for procedures involving valve replacement, according to a new report.
The Pennsylvania Health Care Cost Containment Council released the report, titled “Cardiac Surgery in Pennsylvania,” reviewing outcomes for 29,578 adult patients who underwent coronary arterial bypass surgery or heart valve surgery between Jan. 1, 2014, and March 31, 2016.
In a written statement, Wilkes-Barre General spokeswoman Renita Fennick pointed out that, since March 2016, “our cardiothoracic surgery department is under new leadership, and the surgeon with the highest readmission rate no longer practices at Wilkes-Barre General Hospital.”
The data is adjusted to account for high-risk patients, including those under 30 years old, who left the hospital against medical advice or who were clinically complex cases.
The report includes in-hospital mortality rates and 30-day readmission rates for bypass-only, valve-only and combination surgeries. It also has average hospital charges.
Wilkes-Barre General and Geisinger Wyoming Valley Medical Center in Plains Township are the only two Luzerne County hospitals listed.
Strictly by the numbers, Wilkes-Barre General looks like the better place to get bypass surgery if it doesn’t involve valve surgery. More bypass-only procedures were done there — 290 compared to 216 at Geisinger Wyoming Valley — for considerably less money. Average fees totaled $185,909 at General compared to $235,242 at Geisinger.
The mortality rate was lower at General, 1.3 percent compared to 2.3 percent at Geisinger, though both were within each hospital’s respective “expected range.”
But Geisinger does more valve procedures, 173 total compared to 62 at Wilkes-Barre General. And it has a lower mortality rate, 4 percent compared to 4.8 percent. The fee difference is narrow, with Geisinger averaging $273,887 to Wilkes-Barre General’s $262,674.
Readmission rates within 30 days of bypass-only surgery are nearly the same at both facilities, 10.1 percent at Geisinger and 9.9 percent at General. But the story is different for valve surgery.
At Geisinger Wyoming Valley, the readmission rate for all valve procedures was 10 percent. At Wilkes-Barre General, it was 25.5 percent.
The fact that Wilkes-Barre General does fewer than half the valve procedures done at Geisinger does mean numeric changes can have a bigger impact on percentages. In fact, the number of valve-only procedures at General was so low — 20 — the mortality and readmission rates were not reported.
The statement from Fennick noted “in the past year, our Heart & Vascular Institute has expanded its services and procedures, and we feel confident that our current outcomes are much more favorable.”
The statement pointed to the opening of a valve clinic and — in partnership with Regional Hospital of Scranton, owned by the same for-profit company Commonwealth Health — the addition of transcatheter aortic valve replacement. “This minimally invasive procedure repairs the valve without performing open-heart surgery.”
Statewide, the news was positive. The report compared bypass in-hospital mortality rates to data from 1994, showing a decline from 3.2 percent to 1.5 percent. It also compared valve mortality rates from 2005, when the rate was 5.2 percent, to the new data, with a statewide rate of 3 percent.
Readmission rates have also dropped for both bypass and valve procedures. In 2002-03 the readmission rate for bypass surgery was 12.8 percent; in 2014-15 it was 10.6 percent.
In 2005-06, valve replacement procedures resulted in 17.8 percent readmission statewide, while the rate was 13.3 percent in the new data.
