Changes in the use of coronary artery revascularization procedures in the Department of Veterans Affairs, the National Hospital Discharge Survey, and the Nationwide Inpatient Sample, 1991–1999Report as inadecuate




Changes in the use of coronary artery revascularization procedures in the Department of Veterans Affairs, the National Hospital Discharge Survey, and the Nationwide Inpatient Sample, 1991–1999 - Download this document for free, or read online. Document in PDF available to download.

BMC Health Services Research

, 3:12

First Online: 10 July 2003Received: 13 December 2002Accepted: 10 July 2003DOI: 10.1186-1472-6963-3-12

Cite this article as: Maynard, C. & Sales, A.E. BMC Health Serv Res 2003 3: 12. doi:10.1186-1472-6963-3-12

Abstract

BackgroundThere have been dramatic increases in the number of coronary artery bypass surgeries CABS and percutaneous coronary interventions PCI performed during the last decade. Whether this finding is true for revascularization procedures performed in Department of Veterans Affairs VA medical centers is the subject of this paper.

MethodsThis study compared the number of revascularization procedures and rates of use in the VA, the National Hospital Discharge Survey, and the Nationwide Inpatient Sample. Included were men who underwent isolated CABS and-or PCI, including stenting, between 1991 and 1999, although data for the Nationwide Inpatient Sample were available only between 1993 and 1997. Age adjusted use rates were calculated with the direct method of standardization.

ResultsThe percent of users of VA healthcare 75 years and older increased from 10% in 1991 to 20% in 1999. In the VA, the number of isolated CABS declined from 6227 in 1991 to 6147 in 1999, whereas age adjusted rates declined from 167.6 per 100,000 in 1991 to 107.9 per 100,000 in 1999. In the 2 national surveys, both the estimated numbers of procedures and use rates increased over time. In all 3 settings, there were increases in both numbers and rate of PCI from 1993, although in the VA, use rates decreased from 191.2 per 100,000 in 1996 to 139.7 per 100,000 in 1999. VA use rates for both CABS and PCI were lower than those in the 2 national surveys.

ConclusionAge adjusted rates of CABS and PCI were lower in the VA than in 2 national surveys. Since 1996, there has been a decrease in the rate of use of revascularization procedures in the VA.

List of AbbreviationsVAVeterans Affairs

CABSCoronary Artery Bypass Graft Surgery

PCIPercutaneous Coronary Intervention

Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-3-12 contains supplementary material, which is available to authorized users.

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Author: Charles Maynard - Anne E Sales

Source: https://link.springer.com/







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