ArticleBMC health services research2006
Differences in per capita rates of revascularization and in choice of revascularization procedure for eleven states.
Article in BMC health services research, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Declining use of percutaneous coronary intervention across population groups, 2011-2022.Health affairs scholar · 2026Article
- Regional variation in the use of catheter ablation for patients with arrhythmia in Japan.Journal of arrhythmia · 2021Article
- Factors associated with the rates of coronary artery bypass graft and percutaneous coronary intervention.BMC cardiovascular disorders · 2019Article
- Variation in Management of Patients With Obstructive Coronary Artery Disease: Insights From the Veterans Affairs Clinical Assessment and Reporting Tool (VA CART) Program.Journal of the American Heart Association · 2017Article
- Cataract surgery among Medicare beneficiaries.Ophthalmic epidemiology · 2012Article
- Determinants of variations in coronary revascularization practices.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2012Article
- Chronic coronary artery disease: diagnosis and management.Mayo Clinic proceedings · 2009Review
- Diagnostic-therapeutic cascade revisited: coronary angiography, coronary artery bypass graft surgery, and percutaneous coronary intervention in the modern era.Circulation · 2008Article
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Authors and funding
3 authors.
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Abstract
backgroundA few studies have investigated differences in elective procedure rates across small and medium sized referral regions. The purposes of this study are to investigate differences in revascularizations across 11 entire states and to investigate differences in choice of revascularization procedure (percutaneous coronary intervention (PCI) vs. coronary artery bypass graft (CABG) surgery).
methodsAge-sex adjusted rates per 100,000 population who were 20 or older were calculated for PCI, CABG surgery, and total revascularization for each state. Also, the risk-adjusted proportion of revascularized patients who underwent PCI was calculated for each state and differences were compared.
resultsWe found variations in procedures performed per capita of 1.83-fold for PCI, 1.54-fold for CABG surgery, and 1.54-fold for total revascularization. For patients undergoing revascularization of two or more vessels, the age/sex adjusted maximum rate of 224 per 100,000 population over 20 years old in Florida was 53% higher than the minimum rate of 146 in Colorado. Higher catheterization rates per 1,000 Medicare enrollees and higher percent of white patients were significant predictors of higher revascularization rates, and density of specialists was a significant predictor of catheterization rate. The risk-adjusted percentage of revascularized patients with two or more arteries attempted who underwent PCI ranged from 10.4% in Oregon to 29.0% in Iowa.
conclusionThere are reasonably large differences among states in total revascularization rates and in type of revascularization among revascularization. These differences appear to be related to practice pattern differences. Future effort should be devoted to understanding the reason for these differences and the impact on patients' health and survival.
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