Evidence of systematic duplication by new percutaneous coronary intervention programs.
Evidence of systematic duplication by new percutaneous coronary intervention programs.
复制标题
DOI：
10.1161/circoutcomes.111.000019
复制
发表时间：
2013-07
期刊：
影响因子：
--
通讯作者：
Griffith JL
中科院分区：
文献类型：
--
作者：
Concannon TW;Nelson J;Kent DM;Griffith JL
Evidence suggests that recent and projected future investments in percutaneous coronary intervention (PCI) programs at U.S. hospitals fail to increase access to timely reperfusion for patients with ST segment elevation myocardial infarction (STEMI). We set out to estimate the annual number and costs of new PCI programs in U.S. hospitals from 2004–2008, and to identify the characteristics of hospitals, neighborhoods and states where new PCI programs have been introduced. We estimated a discrete-time hazard model to measure the influence of these characteristics on a hospital’s decision to introduce a new PCI program. In 2008, 1739 U.S. hospitals were capable of performing PCI, a relative increase of 16.5% (251 hospitals) over 2004. The percent of the U.S. population with projected access to timely PCI grew by 1.8%. New PCI programs were more likely to be introduced in areas that already had a PCI program with more competition for market share, near populations with higher rates of private insurance, in states that had weak or no regulation of new cardiac catheterization labs, and in wealthier and larger hospitals. Our data show that new PCI programs were systematically duplicative of existing programs and did not help patients gain access to timely PCI. The total cost of recent U.S. investments in new PCI programs is large and of questionable value for patients.
