2008年から2012年にかけてのメディケア受給者における冠動脈再血管化処置の傾向
Steven D Culler1, Aaron D Kugelmass2, Phillip P Brown2
1From the Rollins School of Public Health, Emory University, Atlanta, GA (S.D.C.); Baystate Health, Springfield, MA (A.D.K.); HealthTrust Purchasing Group, L.P., Nashville, TN (P.P.B., A.W.S.); and Lahey Hospital & Medical Center, Burlington, MA (M.R.R.). sculler@emory.edu.
Circulation
|December 24, 2014
まとめ
2010年以降,メディケア受給者の冠動脈再血管化処置は減少し,外科医による皮膚経冠動脈介入 (PCI) に移行した. これらの心臓の手術における全死亡率は安定したままでした.
科学分野:
- 心血管外科手術についてです.
- 医療サービス 研究 医療サービス
- ゲリアトリック・カルディオロジー
背景:
- 2008年から2012年にかけてのメディケア受給者における冠動脈再血管化の手続きの動向を調査した.
- 処置量の変化と患者の結果に焦点を当ててください.
研究 の 目的:
- 冠動脈再血管化処置の容量と結果の時間的傾向を分析する.
- 冠動脈バイパス移植手術と皮膚経冠動脈介入 (PCI) の結果の比較を図る.
- これらの手順のための施設利用の変化を評価する.
主な方法:
- 2008年から2012年にかけてのメディケア受給者データ (2,768,007件の記録) の遡及分析.
- ICD-9-CM,CPT,APCコードを使用した冠動脈バイパス移植手術および皮膚経冠動脈介入 (PCI) の識別.
- 入院と非入院 (診療室) の両方を含む.
主要な成果:
- 非入院PCIの手続きの有意な増加が観察され,入院PCIの量は減少しました.
- 冠動脈バイパス移植手術の受診者数も,研究期間中に減少した.
- 冠動脈バイパス移植手術はPCIと比較して死亡率が低かったが,全体的な死亡率は安定したままだった.
- あらゆるタイプのリバスカライゼーションの手続きを行う施設の数が増加していることが確認されました.
結論:
- 冠動脈再循環手術の総量は2010年にピークに達し,その後減少した.
- リヴァスキュラライゼーションを受けるメディケア受給者の年間死亡率は,2.1%から2.2%の間で一貫していました.
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