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Mental disorders and revascularization procedures in a commercially insured sample.
Laura E Jones1, Caroline P Carney
1Department of Epidemiology, The University of Iowa College of Public Health, Iowa City, Iowa, USA.
Psychosomatic Medicine
|July 28, 2005
Summary
Adults with mental disorders received similar rates of cardiac revascularization (angioplasty or bypass surgery) as those without mental disorders. Further research is needed to understand disparities in cardiac intervention for mentally ill patients.
Area of Science:
- Cardiology
- Psychiatry
- Health Services Research
Background:
- Patients with mental disorders often experience worse cardiovascular outcomes.
- Understanding disparities in cardiac intervention for this population is crucial.
Purpose of the Study:
- To compare revascularization rates (percutaneous coronary angioplasty and coronary artery bypass graft surgery) between commercially insured adults with and without mental disorders.
Main Methods:
- Retrospective analysis of Blue Cross/Blue Shield of Iowa administrative claims data (1996-2001).
- Logistic regression used to calculate odds ratios for revascularization within 30 days of hospital discharge for myocardial infarction.
Main Results:
- Of 3368 adults hospitalized for myocardial infarction, 40% had a mental disorder.
- Individuals with mental disorders were younger, more likely female, urban, and had higher comorbidity.
- Adjusted analyses showed similar rates of angioplasty (OR 1.10) and bypass surgery (OR 0.89) for patients with and without mental disorders.
Conclusions:
- Revascularization rates were similar between patients with and without mental disorders.
- Differences from prior studies may be due to the younger population and higher comorbidity in the mental disorder group, potentially leading to contraindications.
- Further prospective research is needed to clarify reasons for potential underutilization of cardiac interventions in patients with mental illness.