Widening volume and persistent outcome disparity in valve operations: New York statewide analysis, 2005-2016

A widening volume and persistent outcome disparity was observed for valve surgeries performed in NYS between 2005 and 2016. Plots show average percent market share (left) and average RAMR (right) of top-volume quartile hospitals (Q1) and bottom-volume quartile hospitals (Q4) for valve procedures over time in triannual intervals. There was a nonsignificant trend for greatest-volume hospitals increasing their market share of valve procedures, and a statistically significant trend in improving RAMR. No significant trends were noted in the lowest-volume hospitals. P values represent results of univariate longitudinal analysis using linear mixed models. Error bars represent 95% confidence intervals. N = 9 for each quartile. NYS, New York state; RAMR, risk-adjusted mortality rate; CABG, coronary artery bypass grafting.