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Clinical Decision Support
The slide has a chart showing improvement in quality of care. The caption reads, "In CVD [cardiovascular disease], long history with retrospective analysis of clinical data:"
The chart displays four trends, increasing expected mortality, decreasing observed mortality, decreasing risk-adjusted mortality and decreasing reimbursement from 1990 to 1999. The expected mortality rate for bypass patients has significantly increased by approximately 35% (from about 3.4% to 4.4%). However, over the same period from 1990 to 1999, both the observed (5.5% to 4.2%) and risk-adjusted mortality (5.3% to 3%) in this Medicare coronary artery bypass grafts (CABG) population decreased by approximately 30%. The chart shows that risk-adjusted mortality rates have dropped markedly despite this increase in expected mortality. It is important to note that over this period, Medicare payment rates for CABG surgery decreased approximately 40% as shown in the reimbursement trend (from about $3800 to $2,500).
Source: Ferguson TB Jr. et al. Ann Thorac Surg 2004:73:480-490.
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