– Cardiac care is delivered by many different health care professionals, and the resulting outcomes are a reflection of the whole system of care, rather than being attributable to a particular physician in a centre. Quality outcomes depend not only on a physician's technical skills, but also on the structure and care processes that are found in the environment in which health care is delivered.4
– Some cardiac care centres are more specialized, perform interventions on more complex patients or accept higher-risk patients than average. CIHI is able to adjust for some of these differences across patient populations; however, the administrative data submitted is limited in its ability to capture and adjust for all differences associated with patient populations. Centres with more complex patients may have increased mortality and/or readmission rates because not all aspects of complexity can be adjusted for in the administrative data.
– Transferring patients to a different hospital following a cardiac intervention is normal practice for many cardiac care centres. As such, there are potential learning opportunities beyond the centres included in this indicator.
– Rates with wide confidence intervals should be interpreted with caution as they reflect a less-precise estimate.
– Direct comparisons between cardiac care centres or provinces are discouraged. Comparisons with the Canadian average provide more meaningful information.
– Indicator results do not provide a final conclusion about cardiac care performance and can be used as a first step in an improvement process to identify areas for follow-up and potential improvements.
– There is no comprehensive capture of PCI data in Quebec, so data from Quebec cannot be included in analyses.
– Out-of-hospital deaths are not captured in CIHI's administrative databases.