University of Kentucky hospital, the largest hospital in Lexington, performed the smallest number of heart bypass surgeries, according to annual rankings released July 21 by U.S. News & World Report.
UK officials said the hospital's volume is lower than the city's two other major hospitals because it focuses on the most complex cases.
After 25 years of hospital rankings, U.S. News this year put a special focus on the treatment of five common procedures or conditions, including heart bypass surgery.
U.S. News presents patient volumes in a range. For example, UK's volume ranked "low" at 25 to 83 surgeries. UK, according to U.S. News, has 589 beds. Baptist Health, with 344 beds, ranked "moderately high" at between 193 and 278 cases. St. Joseph, with 298 beds, ranked "high" with at least 279 cases.
In all five core areas of care — bypass surgery, chronic obstructive pulmonary disease, heart failure and hip and knee replacement — U.S. News reported that "very low" volumes — under 25 — had a negative impact on the quality of care a patient received.
In the case of bypass surgery, Baptist Health, St. Joseph and UK all received a 7 out of 13 rating, or "as expected" — not better or worse than expected — for overall survival rate for bypass surgery.
Sue Downs, interim president of St. Joseph, said the hospital benefits from a long history of performing heart surgeries and that helps draw patients. St. Joseph had the first dedicated heart center in Lexington.
"Our heart team is the best in the region, and we know patients are drawn to them," she said.
Ruth Ann Childers, a spokeswoman for Baptist Health, said outreach has been key for Baptist Health. Cardiologists from Lexington travel several times a month to places like Maysville, Mount Sterling and Somerset to see heart patients. If bypass becomes necessary, those doctors refer patients for surgery in Lexington.
She also said Baptist Health, which was rated the No. 1 hospital in Kentucky by U.S. News, has a good reputation across the state when it comes to heart surgery.
Dr. Susan Smyth, medical director at UK's Gill Heart Institute, said volume numbers for the university hospital are lower than Baptist Health or St. Joseph because doctors at UK are more focused on the most complex cases.
UK has found, she said, that many bypass patients are better served at their community hospitals where they can be close to home. She said UK is not in competition with other Lexington hospitals and instead focuses on procedures that community hospitals can't perform, such as heart transplants.
UK performed 13 heart transplants in 2014, according to data collected by the federal Health Resources and Services Administration.
(UK spokeswoman Laura Dawahare said UK performed 17 heart transplants last year, and the difference may be a lag in reporting at the federal level.)
The state's only other heart transplant hospital, Jewish Hospital in Louisville, had a "high" volume of bypass patients, or more than 298. Jewish has 387 beds.
In the region, Vanderbilt University, rated by U.S. News as among the best hospitals in the country for providing heart and heart surgery care, had 38 percent more beds than UK but performed 70 percent more bypass surgeries.