Evidence map›Paper›PMID 23347002›Full record

ArticleHealth services research2013

Resource use trajectories for aged medicare beneficiaries with complex coronary conditions.

Jerome J Federspiel, Sally C Stearns, Laura P D'Arcy, Kimberley H Geissler, Christopher A Beadles, Daniel J Crespin, Timothy S Carey, Joseph S Rossi, Brett C Sheridan

Open access · greenAbstract read
In one paragraph

Article in Health services research, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Jerome J FederspielDepartment of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7411, USA.
Sally C Stearns
Laura P D'Arcy
Kimberley H Geissler
Christopher A Beadles
Daniel J Crespin
Timothy S Carey
Joseph S Rossi
Brett C Sheridan
University of North Carolina at Chapel Hill · USMathematica Policy Research · USMinnesota Department of Health · USSt. Vincent Hospital · US

Funding

MEDICAL SCIENTIST TRAINING PROGRAMT32GM008719 · NIGMS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI DARVILLE, TONI, DESHMUKH, MOHANISH P · 1999 to 2023
$15.1M
UNC-CH TRAINING PROGRAM IN HEALTH SERVICES RESEARCHT32HS000032 · AHRQ · UNIV OF NORTH CAROLINA CHAPEL HILL · PI HOLMES, GEORGE M · 1989 to 2024
$8.2M
PREDOCTORAL/POSTDOCTORAL TRAINING HLTH CARE AGING REST32AG000272 · NIA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI DILWORTH-ANDERSON, PEGGYE · 2001 to 2013
$2.3M
Acute Coronary Syndrome Outcomes for Medicare PatientsR01AG025801 · NIA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI STEARNS, SALLY C · 2007 to 2009
$794k
Impacts of Cost Sharing and Echocardiography on Outpatient Care of Heart FailureF30HL110483 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI FEDERSPIEL, JEROME JEFFREY · 2011 to 2014
$133k
Changes in Health Care Access and Utilization in the US-Mexico Border RegionR36HS021074 · AHRQ · UNIV OF NORTH CAROLINA CHAPEL HILL · PI GEISSLER, KIMBERLEY LYNN H · 2011 to 2011
$43k
AHRQ HHS R36 HS021074AHRQ HHS R36-HS021074AHRQ HHS T32 HS000032AHRQ HHS T32-HS000032NHLBI NIH HHS F30 HL110483NHLBI NIH HHS F30-HL110483NIA NIH HHS R01 AG025801NIA NIH HHS R01-AG025801NIA NIH HHS T32 AG000272NIA NIH HHS T32-AG000272NIGMS NIH HHS T32 GM008719NIGMS NIH HHS T32-GM008719
6 · The paper itself

Abstract

objectiveTo use coronary revascularization choice to illustrate the application of a method simulating a treatment's effect on subsequent resource use. DATA SOURCES: Medicare inpatient and outpatient claims from 2002 to 2008 for patients receiving multivessel revascularization for symptomatic coronary disease in 2003-2004. STUDY

designThis retrospective cohort study of 102,877 beneficiaries assessed survival, days in institutional settings, and Medicare payments for up to 6 years following receipt of percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).

methodsA three-part estimator designed to provide robust estimates of a treatment's effect in the setting of mortality and censored follow-up was used. The estimator decomposes the treatment effect into effects attributable to survival differences versus treatment-related intensity of resource use. PRINCIPAL

findingsAfter adjustment, on average CABG recipients survived 23 days longer, spent an 11 additional days in institutional settings, and had cumulative Medicare payments that were $12,834 higher than PCI recipients. The majority of the differences in institutional days and payments were due to intensity rather than survival effects.

conclusionsIn this example, the survival benefit from CABG was modest and the resource implications were substantial, although further adjustments for treatment selection are needed.

Indexed as

AgedAged, 80 and overAmbulatory CareAngioplasty, Balloon, CoronaryCardiac CatheterizationCohort StudiesCoronary Artery BypassCoronary Artery DiseaseCosts and Cost AnalysisFemaleHealth ExpendituresHealth ResourcesHumansLength of StayMaleMedicare

Identifiers

PMID23347002
PMCPMC3625399
OpenAlexW2024599576

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.