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Type of Cardiac Service Lines CARDIAC CARE SERVICE LINES

There are many types of heart problems and ways to treat them. VHI groups these different conditions and treatments into service lines to better compare care provided.

MEDICAL CARDIOLOGY includes diagnosing and therapy for heart disease. AnginaAngina
literally means "choking pain," and angina pectoris refers to a painful or uncomfortable sensation in the chest that occurs when part of the heart does not receive enough oxygen due to disease in the coronary arteries that supply blood to the heart.
More info at:
www.ehealthmd.com/library/ angina/ANG_whatis.html
, congestive heart failureCongestive Heart Failure (CHF)
or heart failure, is a condition in which the heart can not pump enough blood to the body's other organs.

For more information on signs and symptoms, tests, and treatment, visit: www.americanheart.org/ presenter.jhtml?identifier=4585
and acute myocardial infarction (AMI)Acute Myocardial Infarction (AMI)
heart attack occurs when the supply of blood and oxygen to an area of heart muscle is blocked, usually by a clot in a coronary artery. If treatment is not started quickly, the affected area of heart muscle begins to die.
More info at: www.nhlbi.nih.gov/health/dci/ Diseases/HeartAttack/ HeartAttack_WhatIs.html
are all examples of heart conditions. When treatment for these conditions does not include surgery, VHI has grouped them into the MEDICAL CARDIOLOGY service line.

INVASIVE CARDIOLOGY includes patients with medical conditions generally described in the medical cardiology service line that also had surgery. Surgeries include cardiac catheterizationCardiac Catheterization
or angiogram is a procedure that identifies possible problems with your heart or its arteries. During a cath, a thin plastic tube, called a catheter, is inserted into a blood vessel in your groin or arm. The catheter is guided up toward your heart. A special dye is injected into the catheter so X-rays can show if you have any artery blockage or other heart problems. www.americanheart.org/ presenter.jhtml?identifier=4491
, cardiac pacemaker insertion, balloon angioplastyBalloon Angioplasty
(AN-je-o-plast-tee) involves temporarily inserting and expanding a tiny balloon at the site of your blockage to help widen a narrowed artery.
and placement of cardiac stentsCardiac Stent
angioplasty is usually combined with implantation of a small metal coil called a stent in the clogged artery to help prop it open and decrease the chance of it narrowing again (restenosis).
.

OPEN HEART SURGERY includes procedures such as coronary artery bypass surgery (CABG)Coronary Artery Bypass Graft (CABG)
also coronary artery bypass surgery, heart bypass or bypass surgery is a surgical procedure performed to relieve angina and reduce the risk of death from coronary artery disease. Arteries and/or veins from elsewhere in the patient's body are grafted from the aorta to the coronary arteries to bypass atherosclerotic narrowings and improve the blood supply to the coronary circulation supplying the myocardium (heart muscle).
More info: http://en.wikipedia.org/ wiki/Coronary_artery _bypass_surgery
and cardiac valve proceduresCardiac Valve Procedure
When a valve in the heart is not properly controlling the flow of blood, cardiac surgeons repair or replace the defective valve.
More info:
www.americanheart.org/ presenter.jhtml?identifier=4592
.

Click here to view the version 24 3M APR-DRGs used for each Service Line



MEDICAL CARDIOLOGY
190-ACUTE MYOCARDIAL INFARCTION
193-ACUTE & SUBACUTE ENDOCARDITIS
194-HEART FAILURE 1
196-CARDIAC ARREST
198-ANGINA PECTORIS & CORONARY ATHEROSCLEROSIS
199-HYPERTENSION
200-CARDIAC STRUCTURAL & VALVULAR DISORDERS
201-CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS
203-CHEST PAIN
205-CARDIOMYOPATHY
206-MALFUNCTION,REACTION & COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE
207-OTHER CIRCULATORY SYSTEM DIAGNOSES

INVASIVE CARDIOLOGY
161-CARDIAC DEFIBRILLATOR & HEART ASSIST IMPLANT
170-PERM CARDIAC PACEMAKER IMPL W AMI, HEART FAILURE OR SHOCK
171-PERM CARDIAC PACEMAKER IMPLANT W/O AMI, HEART FAILURE OR SHOCK
174-PERCUTANEOUS CARDIOVASCULAR PROCEDURES W AMI 2
175-PERCUTANEOUS CARDIOVASCULAR PROCEDURES W/O AMI 2

176-CARDIAC PACEMAKER & DEFIBRILLATOR DEVICE REPLACEMENT
177-CARDIAC PACEMAKER & DEFIB REVISION EXCEPT DEVICE REPLACEMENT
191-CARDIAC CATHETERIZATION W CIRC DISORDEXC ISCHEMIC HEART DISEASE 3
192-CARDIAC CATHETERIZATION FOR ISCHEMIC HEART DISEASE 3
.

OPEN HEART SURGERY

160-MAJOR CARDIOTHORACIC REPAIR OFHEART ANOMALY
162-CARDIAC VALVE PROCEDURES W CARDIAC CATH
163-CARDIAC VALVE PROCEDURES W/O CARDIAC CATH
165-CORONARY BYPASS W/ CARDIAC CATH OR PERCUTANEOUS CARDIAC PROCEDURE 4
166-CORONARY BYPASS W/O CARDIAC CATH OR PERCUTANEOUS CARDIAC PROCEDURE 4

167-OTHER CARDIOTHORACIC PROCEDURE



1 APR-DRG 194 is also grouped under the sub-category "HEART FAILURE"

2 APR-DRG 174 and APR-DRG 175 are also grouped under the sub-category "PERCUTANEOUS CARDIOVASCULAR PROCEDURES"

3 APR-DRG 191 and APR-DRG 192 are also grouped under the sub-category "CARDIAC CATHERTIZATION"

4 APR-DRG 166 and APR-DRG 167 are also grouped under the sub-category "CABG"


The All Patient Refined-Diagnosis Related Groups were developed by 3M Health Information Systems.

 

Click here to view more information regarding outcomes of care related to IN-HOSPITAL DEATH and 30-DAY READMISSION RATES

 

VHI provides information on in-hospital deaths and death rates occurring during a cardiac care hospitalization. Lower death rates than what you would expect when comparing similar patients are better.  VHI has excluded certain patients from this analysis including those receiving hospice care.  The Methodology section provides more detail on what is excluded.

 

30-Day Readmission Rates are also provided. Readmission rates are important because they may reflect how complete care was during the hospital stay and whether the patient received or acted upon follow-up care during the first hospitalization.  

VHI identifies whether patients are readmitted within thirty days of the original admission and calculates readmission rates.  Not all readmissions are included--just those that appear to be related to the first admission.  If someone was hospitalized for a medical cardiology problem and was readmitted two weeks later for medical cardiology, VHI would consider that related. If the same medical cardiology patient were readmitted after an automobile accident or for delivery of a baby, VHI would not consider that as a related readmission.

 

As with deaths, lower 30-day readmission rates than expected when comparing similarly ill patients are considered better. 

For outcome measures, VHI uses symbols to note whether death and readmission rates are less than expected, as expected, or higher than expected.