California Elective Percutaneous Coronary Intervention Program Report

The California Elective Percutaneous Coronary Intervention (PCI) Program Report provides information on the quality of elective PCIs at California general acute care hospitals certified to perform PCIs without on-site cardiac surgery.

PCI is a non-surgical technique for treating coronary artery disease (CAD) used to open narrowed coronary arteries. CAD occurs when plaque builds up in the coronary arteries, limiting the flow of blood to your organs and other parts of your body which can lead to a heart attack or stroke. Elective PCIs specifically refer to scheduled PCIs in contrast to urgent or emergent PCIs that are scheduled on an ad hoc basis.

The following report provides three performance outcomes measures, PCI mortality, post-PCI stroke, and post-PCI emergency coronary artery bypass graft (CABG) surgery.

California Elective PCI Outcomes Reports

Executive Summary

Percutaneous coronary intervention (PCI) is a major coronary revascularization strategy and is one of the most common hospital-based interventional procedures performed in the United States. Coronary artery bypass graft (CABG) and PCI are both interventions for the treatment of coronary artery disease. PCI procedures are less invasive than CABG and may result in quicker hospital discharge and return to daily activities.

Until recently, elective PCIs in California were prohibited in hospitals without on-site cardiac surgery. On January 1, 2009, the Elective PCI Pilot Program was implemented pursuant to Senate Bill 891 (Chapter 295, Statutes of 2008). This program authorized six California hospitals without on-site cardiac surgery to perform elective PCI with cardiac surgery available at a nearby hospital.

Senate Bill 906 (Chapter 368, Statutes of 2015) made permanent the Elective PCI Program and authorized the California Department of Public Health (CDPH) to certify hospitals that do not have on-site cardiac surgery and are licensed to provide cardiac catheterizations, to perform elective PCIs. These hospitals must meet specific requirements to perform elective PCIs for eligible patients. In addition, current law requires the Office of Statewide Health Planning and Development to use data collected by the American College of Cardiology’s National Cardiovascular Data Registry from certified hospitals to create annual reports for those hospitals. 1

The California Elective Percutaneous Coronary Intervention Program Report, 2016 is the first outcomes report on the eight California hospitals certified to perform PCIs without on-site cardiac surgery.

The three outcome measures presented are risk-adjusted, which is a statistical technique that enables fair comparison of hospitals even though some hospitals treat sicker patients.

Risk-adjusted rates for the certified hospitals are compared to overall statewide rates derived from all 135 hospitals that performed PCIs in 2016 (8 certified hospitals and 127 non-program hospitals with on-site cardiac surgery). Results are reported for elective and all PCIs including elective and primary PCIs. However, the report only identifies hospitals certified to perform PCIs without on-site cardiac surgery; it does not include information on hospitals with on-site cardiac surgery. Please note that individual hospitals from the two groups cannot be directly compared.

The eight certified hospitals in this report include:

  • Clovis Community Medical Center
  • Kaiser Foundation Hospital - Rehabilitation Center Vallejo
  • Kaiser Foundation Hospital - Roseville
  • Kaiser Foundation Hospital - South Sacramento
  • Kaiser Foundation Hospital - Walnut Creek
  • Los Alamitos Medical Center
  • St. Rose Hospital (Hayward)
  • Sutter Roseville Medical Center

The report includes the following risk-adjusted outcomes:

  • Mortality includes all deaths that occurred at the facility where the PCI was performed regardless of length of stay or patient status (i.e., inpatient or outpatient).
  • Post-PCI Stroke includes all ischemic or hemorrhagic strokes that occurred after the PCI and did not resolve in 24 hours.
  • Post-PCI Emergency CABG surgery includes all emergency or salvage CABG surgeries that occurred in hospital (including transfers to other hospitals) after the PCI.

Information in this report is made available to publicly inform about outcomes at elective PCI certified hospitals. This report will also assist in monitoring the safety and feasibility of PCIs performed at hospitals without on-site cardiac surgery in California. In addition, the information in this report will provide hospitals performance measures they can use in their review of internal processes of care and quality improvement activities, help payers and employers spend their healthcare dollars more wisely, and help consumers make more informed healthcare decisions.

1 California Health and Safety Code Section 1256.01(f)
Technical Details

Additional information about these outcome measures can be found in the OSHPD Technical Note for the California Elective Percutaneous Coronary Intervention Program Report, 2016.

Data Download

Click the link below to access the mortality, post-PCI stroke, and post-PCI emergency CABG results for all hospitals:

Key Findings

Mortality Findings
  • The elective PCI mortality rate for certified hospitals was 0.00 percent (no deaths) compared to a statewide rate of 0.25 percent.
  • The all PCI mortality rate for certified hospitals was 1.80 percent compared to a statewide rate of 2.28 percent.
Post-PCI Stroke Findings
  • The elective PCI stroke rate for certified hospitals was 0.00 percent (no post-PCI strokes) compared to a statewide rate of 0.13 percent.
  • The all PCI stroke rate for certified hospitals was 0.49 percent compared to a statewide rate of 0.38 percent.
Post-PCI Emergency CABG Surgery Findings
  • The elective PCI emergency CABG rate for certified hospitals was 0.00 percent (no post-PCI emergency CABGs) compared to a statewide rate of 0.11 percent.
  • The all PCI emergency CABG rate for certified hospitals was 0.07 percent compared to a statewide rate of 0.26 percent.

If you need to contact the Elective PCI Program please email us at PCI@oshpd.ca.gov.

Data Pulse - Why Use Risk-Adjustment?

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Find out the purpose of risk-adjustment comparisons in OSHPD data
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This page was last updated on Friday, April 20, 2018.

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