Indicator Metadata

NameCoronary Artery Bypass Graft (CABG) Rate
Short/Other Names

CABG

Description

This indicator measures the age-standardized rate of coronary artery bypass graft (CABG) surgery performed on inpatients in acute care hospitals, per 100,000 population age 18 and older.

For further details, please see the General Methodology Notes.

InterpretationDoes not apply to this measure (i.e., there is no predefined preference for the measure score)
HSP Framework Dimension

Health System Inputs and Characteristics: Health system resources

Areas of Need

Not applicable

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

National, Province/Territory, Region

Indicator Results

http://www.cihi.ca/hirpt/?language=en

Identifying Information
NameCoronary Artery Bypass Graft (CABG) Rate
Short/Other Names

CABG

Indicator Description and Calculation
Description

This indicator measures the age-standardized rate of coronary artery bypass graft (CABG) surgery performed on inpatients in acute care hospitals, per 100,000 population age 18 and older.

For further details, please see the General Methodology Notes.

Calculation: Description

(Total number of discharges for CABG for inpatients age 18 and older ÷ total mid-year population age 18 and older) × 100,000 (age adjusted)

Unit of Analysis: Single admission

Calculation: Geographic Assignment

Place of residence

Calculation: Type of Measurement

Rate - Per 100,000

Calculation: Adjustment Applied

Age-adjusted

Calculation: Method of Adjustment

Direct Standardization
Standard Population:
Canada 2011

Denominator

Description:
Total mid-year population age 18 and older

Numerator

Description:
Total number of discharges for CABG for inpatients age 18 and older

Inclusions:
1. CABG is identified as the following procedure code recorded in any position of the procedure code fields:

CCP: 48.1^

ICD-9-CM: 36.1

CCI: 1.IJ.76^^

2. Age at admission 18 years and older

3. Sex recorded as male or female

4. Admission to an acute care institution (Facility Type Code = 1)

Exclusions:
1. Newborn, stillbirth or cadaveric donor records (Admission Category = N, R or S)

2. CABG can be performed in designated cardiac centres only; therefore, procedures reported by facilities without on-site CABG services were excluded from the indicator calculation.

3. Procedures coded as out of hospital and abandoned after onset (Intervention Status Attribute = A or OOH Indicator Flag = Y)

Background, Interpretation and Benchmarks
Rationale

As with other types of surgical procedures, variation in CABG surgery rates can be attributed to numerous factors, including differences in population demographics, physician practice patterns and availability of services. In cases amenable to treatment with less-invasive procedures, percutaneous coronary intervention (PCI), an alternative intervention to improve blood flow to the heart muscle, may be used. Variations in the extent to which PCI is utilized may result in variations in the rate of bypass surgery.

Interpretation

Does not apply to this measure (i.e., there is no predefined preference for the measure score)

HSP Framework Dimension

Health System Inputs and Characteristics: Health system resources

Areas of Need

Not applicable

Targets/Benchmarks

Benchmarks have not been identified for this indicator.

References

Cardiac Care Network of Ontario Consensus Panel on Target Setting. Final Report and Recommendations. Toronto, Ont.: CCN, 2004. Accessed from <http://www.ccn.on.ca/ccn_public/UploadFiles/files/Cons_Panel_Target_Setting_FRR.pdf>.

Conigliaro, J. et al. "Understanding Racial Variation in the Use of Coronary Revascularization Procedures: The Role of Clinical Factors." Archives of Internal Medicine 160 (2000): pp. 1329-1335.

Faris, P. D. et al. "Diagnostic Cardiac Catheterization and Revascularization Rates for Coronary Heart Disease." Canadian Journal of Cardiology 20 (2004): pp. 391-397.

Institute for Clinical Evaluative Sciences. Cardiovascular Health and Services in Ontario. Toronto, Ont.: ICES, 1999.

Yap, A. G. et al. "Coronary Artery Bypass Surgery on Small Patients." Journal of Invasive Cardiology 12 (2000): pp. 242-246.

Availability of Data Sources and Results
Data Sources

DAD, HMDB

Available Data Years

Type of Year:
Fiscal
First Available Year:
1997
Last Available Year:
2015

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

National, Province/Territory, Region

Result Updates
Update Frequency

Every year

Indicator Results

Web Tool:
Health Indicators E-Publication
URL: http://www.cihi.ca/hirpt/?language=en

Updates

Not applicable

Quality Statement
Caveats and Limitations

Some of the residents in New Brunswick's Zone 4 and Zone 5 receive CABG procedures in Quebec (there is a referral agreement between Quebec and New Brunswick). Due to differences in data collection in MED-ECHO data, with or without Quebec data, we can not assign these patients to the regions; thus the CABG rates for these 2 regions will be suppressed until they stop referring their patients to Quebec.

Trending Issues

This data was not produced for fiscal year 2012–2013.

Comments

CABG operations can be performed in designated cardiac centres only; therefore, procedures reported by facilities without on-site CABG services were excluded from the indicator calculation.