Clinical InvestigationsInterventional CardiologyIndications for percutaneous coronary interventions performed in US hospitals: a report from the NCDR®
Section snippets
Data
We used Medicare Provider and Analysis Review (MedPAR) Part A public use files to identify all hospitals performing ≥1 PCIs between 2001 and 2005 based on the International Classification of Diseases, Ninth Clinical Modification procedure codes (36.01, 36.02, 36.05, and 36.06 (n = 1,609 hospitals). The Part A files contain discharge abstract data for all fee-for-service Medicare patients discharged from acute care hospitals with the exception of Medicare managed care enrollees.14 Data elements
Results
Our study sample consisted of 1,113,554 patients admitted to 694 hospitals. Most of the hospitals in our sample were NFP, and most of the specialty hospitals are in the south (Table I). Major teaching hospitals tended to be larger, and specialty hospitals, smaller as compared with NFP and FP hospitals. Likewise, major teaching hospitals and specialty hospitals were more likely to have cardiac surgery backup and performed higher volumes of PCI, as compared with NFP and FP hospitals.
Women made up
Discussion
In an analysis of data from a large registry of US patients who underwent PCI, we found that overall, a small proportion of procedures (4%) were performed for patients with no clear indications for the procedure. We found only modest variation among the different hospital organizational structures, with specialty hospitals performing the greatest proportion of PCIs with unclear indications. However, there was marked variation among individual hospitals, with 17% of hospitals providing >1 in 5
Disclosures
The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. The funding sources had no role in the analyses or drafting of the manuscript. None of the authors have any conflicts of interest. The views expressed in this article represent those of the author(s), and do not necessarily represent the official views of the NCDR or its associated professional societies identified at www.ncdr.com.
Acknowledgements
Mr House and Dr Spertus had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
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Dr Cram was supported by a K23 career development award (RR01997201) from the NCRR at the NIH and the Robert Wood Johnson Physician Faculty Scholars Program. Dr Cram receives support from the Department of Veterans Affairs. This work is also funded by R01 HL085347-01A1 from NHLBI at the NIH.