Differential Time Trends of Outcomes and Costs of Care for Acute Myocardial Infarction Hospitalizations by ST Elevation and Type of Intervention in the United States, 2001–2011

DSpace/Manakin Repository

Differential Time Trends of Outcomes and Costs of Care for Acute Myocardial Infarction Hospitalizations by ST Elevation and Type of Intervention in the United States, 2001–2011

Citable link to this page

 

 
Title: Differential Time Trends of Outcomes and Costs of Care for Acute Myocardial Infarction Hospitalizations by ST Elevation and Type of Intervention in the United States, 2001–2011
Author: Sugiyama, Takehiro; Hasegawa, Kohei; Kobayashi, Yasuki; Takahashi, Osamu; Fukui, Tsuguya; Tsugawa, Yusuke

Note: Order does not necessarily reflect citation order of authors.

Citation: Sugiyama, Takehiro, Kohei Hasegawa, Yasuki Kobayashi, Osamu Takahashi, Tsuguya Fukui, and Yusuke Tsugawa. 2015. “Differential Time Trends of Outcomes and Costs of Care for Acute Myocardial Infarction Hospitalizations by ST Elevation and Type of Intervention in the United States, 2001–2011.” Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease 4 (3): e001445. doi:10.1161/JAHA.114.001445. http://dx.doi.org/10.1161/JAHA.114.001445.
Full Text & Related Files:
Abstract: Background: Little is known whether time trends of in‐hospital mortality and costs of care for acute myocardial infarction (AMI) differ by type of AMI (ST‐elevation myocardial infarction [STEMI] vs. non‐ST‐elevation [NSTEMI]) and by the intervention received (percutaneous coronary intervention [PCI], coronary artery bypass grafting [CABG], or no intervention) in the United States. Methods and Results: We conducted a serial cross‐sectional study of all hospitalizations for AMI aged 30 years or older using the Nationwide Inpatient Sample, 2001–2011 (1 456 154 discharges; a weighted estimate of 7 135 592 discharges). Hospitalizations were stratified by type of AMI and intervention, and the time trends of in‐hospital mortality and hospital costs were examined for each combination of the AMI type and intervention, after adjusting for both patient‐ and hospital‐level characteristics. Compared with 2001, adjusted in‐hospital mortality improved significantly for NSTEMI patients in 2011, regardless of the intervention received (PCI odds ratio [OR] 0.68, 95% CI 0.56 to 0.83; CABG OR 0.57, 0.45 to 0.72; without intervention OR 0.61, 0.57 to 0.65). As for STEMI, a decline in adjusted in‐hospital mortality was significant for those who underwent PCI (OR 0.83; 0.73 to 0.94); however, no significant improvement was observed for those who received CABG or without intervention. Hospital costs per hospitalization increased significantly for patients who underwent intervention, but not for those without intervention. Conclusions: In the United States, the decrease in in‐hospital mortality and the increase in costs differed by the AMI type and the intervention received. These non‐uniform trends may be informative for designing effective health policies to reduce the health and economic burdens of AMI.
Published Version: doi:10.1161/JAHA.114.001445
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392430/pdf/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:15035008
Downloads of this work:

Show full Dublin Core record

This item appears in the following Collection(s)

 
 

Search DASH


Advanced Search
 
 

Submitters