Availability of Cardiac Technology: Trends in Procedure Use and Outcomes for Patients with Acute Myocardial Infarction

This study examines temporal trends in the use and outcomes of cardiac procedures for patients hospitalized with acute myocardial infarction in Department of Veterans Affairs (VA) hospitals with and without invasive cardiac services. Between 1988 and 1994, there was striking overall growth in the us...

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Bibliographic Details
Published in:Medical care research and review 1998-06, Vol.55 (2), p.239-254
Main Authors: Wright, Steven M., Petersen, Laura A., Daley, Jennifer
Format: Article
Language:English
Subjects:
Acute Disease
Aged
Angioplasty, Balloon, Coronary - utilization
Availability
Biological and medical sciences
Cardiac Catheterization - utilization
Coronary Artery Bypass - utilization
Factors
Health Services Accessibility - statistics & numerical data
Heart attacks
Hospitals
Hospitals, Veterans - statistics & numerical data
Humans
Male
Medical procedures
Medical sciences
Medical technology
Middle Aged
Myocardial infarction
Myocardial Infarction - mortality
Myocardial Infarction - therapy
Outcome and Process Assessment (Health Care)
Outcomes
Patient Admission
Patients
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
United States
USA
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Summary:This study examines temporal trends in the use and outcomes of cardiac procedures for patients hospitalized with acute myocardial infarction in Department of Veterans Affairs (VA) hospitals with and without invasive cardiac services. Between 1988 and 1994, there was striking overall growth in the use of cardiac procedures in the VA. Over this time period, the authors found persistent variation in the use of cardiac procedures but diminished differences in patient survival among patients admitted to different types of hospitals. Growth of cardiac procedure use and improvements in patient survival were most significant in hospitals without on-site invasive cardiac services. We were unable to determine whether survival gains were associated with increased procedure use or unmeasured improvements in the process of care. These trends raise intriguing questions about access to and outcomes of cardiac procedures in health systems composed of hospitals with and without a full complement of on-site invasive cardiac services.
ISSN:1077-5587
1552-6801
DOI:10.1177/107755879805500205