Objectives Quality collaboratives improve quality of care at the hospital and collaborative levels, but less is understood about how such efforts affect patient-level disparities. This study evaluated how a quality improvement (QI) effort (increasing multiarterial grafting during coronary artery bypass grafting (CABG)) translated into populations which historically receive lower-quality care (females and patients of low socioeconomic status).
Design Retrospective cohort study. Setting All non-federal hospitals in the state of Michigan that perform cardiac surgery and participate in a statewide collaborative database (n=33).
Participants Patients undergoing first-time, isolated CABG receiving at least two bypass grafts from 2011 to 2022 were identified. Primary endpoints Association of sex and socioeconomic status with multiarterial grafting was evaluated across the study period.
The distressed community index (DCI), a socioeconomic ranking (0 - not distressed, 100 - severely distressed), was matched to the patient's zip code. Hierarchical regression modelling was performed to associate DCI and sex with multiarterial grafting, incorporating patient factors and hospital and surgeon effects.
BMJ Open published a clinical update in Research Highlights on 07 Apr 2026.
The item focuses on Evaluation of equity in quality improvement for multiarterial grafting in females and patients with low socioeconomic status: retrospective analysis of a statewide collaborative database.
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