Cardiac Surgery and Intervention Improvement Research
Our primary source of data for cardiac surgery and intervention improvement research is the Northern New England Cardiovascular Disease Study Group (NNECDSG), based in Dartmouth-Hitchcock Medical Center. This consortium contains cardiac surgery and intervention data from either medical centers in Northern New England, including Catholic Medical center in Manchester, NH; Central Maine Medical Center in Lewiston, ME; Concord Hospital in Concord, NH; Dartmouth-Hitchcock Medical Center in Lebanon, NH; Eastern Maine Medical Center in Bangor, ME; Fletcher Allen Health Care in Burlington, VT; and Maine Medical Center in Portland, ME.
We also frequently use data from the Society of Thoracic Surgeons (STS) National Database. There are three sections of the National Database: General Thoracic, Adult Cardiac, and Congenital Heart Surgery. These registries compile information from over ninety percent of all organizations in the United States that perform cardiac surgery, containing nearly six million surgical records.
Hospital Penalty Research
For our hospital penalty work, we have used the following publicly available data sources:
- Quarterly Census of Employment and Wages data from the Bureau of Labor Statistics
- Local Area Unemployment statistics data from the Bureau of Labor Statistics
- The Dartmouth Atlas of Health Care data
- Medicare Hospital Readmission Reduction Program data
- American Community Survey
The Census of Employment and Wages from the Bureau of Labor Statistics collects employment and wage data across the United States. Ninety-eight percent of jobs employed in the U.S. are included in this database. It is available in various divisions: county-level, metropolitan statistical area-level, state-level, and national level. These reports are released quarterly.
The Local Area Unemployment Statistics dataset includes employment and unemployment estimates for the following regional designations: Census regions and divisions, States, Metropolitan Statistical Areas and Metropolitan NECTAS (New England City and Town Areas), Metropolitan Divisions and NECTA Divisions, Micropolitan Statistical Areas and Micropolitan NECTAs, Combined Metropolitan Statistical Areas and Combined NECTAs, Small Labor Market Areas, Counties and county equivalents, Cities of 25,000 population or more, Cities and towns in New England regardless of population. These data can be used as a measure of local or regional economic health.
The Dartmouth Atlas project uses Medicare data to show the geographical distribution and variation of health care services utilization. The Atlas includes information about the use of health care services at multiple levels: national, regional, local, and institution-specific. Within the broader regional category, the Atlas has developed two new regional definitions to analyze health care utilization: the Hospital referral region (HRR) and the hospital service area (HSA). HRRs are regional representations of health care markets for specialty care, while HSAs are local representations of markets for more typical health care purposes.
The Hospital Readmission Reduction Program (HRRP) was established under the Affordable Care Act. Under this program, hospitals with excess readmissions are penalized via reduced reimbursements from the Centers for Medicare & Medicaid Services (CMS). The publicly available dataset from the HRRP includes center-specific data, such as acute myocardial infarction (AMI), heart failure (HF), and pneumonia readmissions.
The American Community Survey (ACS) database contains a large range of demographic and socioeconomic information, including measures of educational attainment, poverty status, and insurance coverage, drawn from a representative sample of U.S. communities. The ACS compiles information for various geographic areas, including national-, state-, and county-level data.
This MACD calculator references our work and is available to the public.