High rates of California heart procedures
High rates of California heart procedures raise cost, health quality concerns

About this project

Residents in the Northern California town of Clearlake have been having two common heart procedures at five and six times the state average. Rates are also high across a wide swath of the Central Valley. These elevated numbers are partly a result of widespread health problems that show up in the population. But a new study suggests that the high rates go well beyond that, and researchers say the biggest cause may be clinical practice decisions made by doctors. The findings could have enormous implications for health costs and the quality of care. Insurers and government agencies are taking up the cause, increasingly using these so-called variation studies to pressure doctors to change their practices.


Coronary graphic

A consumer’s guide to heart procedures

Q: What is coronary angiography?

About this project

This project is a partnership between The San Francisco Chronicle and the California HealthCare Foundation Center for Health Reporting. The center is funded by the nonpa

Database: Statewide heart surgical procedures

Database shows rates of heart surgical procedures for 208 geographical areas in California, called Hospital Service Areas (HSA).  They in turn are part of 24 large geographical areas called Hospital Referral Regions (HRR).

Laurence Baker’s methodology for data analysis

For this study, Stanford Professor Laurence Baker analyzed five years of statewide hospital (and some outpatient) discharge data from the 

Technical Report: Methodology for Heart Procedures

Technical Report: Measure development for the Campaign for Effective Patient Care using patient discharge data

Town’s high heart procedure rates raise questions on treatment, costs

This story originally appeared in the San Francisco Chronicle. 

Variation Report: Advisory Committee

Lance Lang, MD, FAAFP Chair, Advisory Committee Consulting Medical Director, Health Dialog Clinical Director, California Quality Collaborative

Classes help decrease weight-loss surgeries

Doctors and hospitals in the Sacramento region had mixed success in their attempts to rein in medical procedures that were being done at higher rates than the norm.

S.F. experiment aims to improve medical treatment, lower costs

Researchers long ago established that certain medical procedures are performed at dramatically different rates from place to place, and that these disparities affect the quality and cost of health care.

Local patients more likely to get invasive heart procedures

Imagine this: A 35-year-old woman comes to the doctor for vague chest pain without a clear cause.

Valley heart procedure rates among highest in California

People who live between Fresno and Bakersfield are more likely to undergo procedures for clogged arteries than almost any other Californians, according to a new study.

Reporter Emily Bazar Featured on Capital Public Radio

Senior Writer Emily Bazar appeared on Capital Public Radio's Insight program today to discuss her in-depth report on high rates of heart procedures in certain California communities. Bazar published her two-part series in the San Francisco Chronicle...

Reporter Emily Bazar featured on Valley Public Radio

Senior Writer Emily Bazar appeared on Valley Public Radio's Valley Edition program today to discuss her in-depth report on high rates of heart procedures in certain California communities. Bazar published her two-part series in the San Francisco...

Blog Posts

Reporter Emily Bazar Featured on Capital Public Radio

Senior Writer Emily Bazar appeared on Capital Public Radio's Insight program today to discuss her in-depth report on 

Elective angioplasty: When is it appropriate?

When I started doing the reporting for our recently published series about Californians u

Series on variation sparks intense, varied response

This weekend, we launched a series in The San Francisco Chronicle abou



Lauren M. Whaley

Freelance journalist Lauren M. Whaley is a photographer, radio producer and print reporter specializing in topics related to mental illness, reproductive health care and health disparities. She is also a childbirth photographer.This year, She is working on a series about how low-income parents access care for perinatal mental illnesses. The project is funded in part by the Rosalynn Carter Fellowships for Mental Health Journalism.She was a 2016-17 Knight Science Journalism Fellow at the Massachusetts Institute for Technology.Her work has been recognized by the Association of Health Care Journalists, the Scripps Howard Foundation and the Public Radio Exchange (PRX) STEM story project. She has contributed radio, video, photography and written stories to KQED Public Radio, Southern California Public Radio, the San Jose Mercury News, the New York Times and other media outlets. For six years, she worked as the Center for Health Reporting's multimedia journalist. She is a past president of the national organizationJournalism and Women Symposium (JAWS) and spent her early 20s leading canoe expeditions for young women, including a solo-led 45-trip in the Canadian Arctic. She is based in Los Angeles.

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