Recent Declines in Hospitalizations for Acute Myocardial Infarction for Medicare Fee-for-Service Beneficiaries Progress and Continuing Challenges
Recent Declines in Hospitalizations for Acute Myocardial Infarction for Medicare Fee-for-Service Beneficiaries Progress and Continuing Challenges
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DOI：
10.1161/circulationaha.109.862094
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发表时间：
2010-03-23
期刊：
影响因子：
37.8
通讯作者：
Krumholz, Harlan M.
中科院分区：
文献类型：
--
作者：
Chen, Jersey;Normand, Sharon-Lise T.;Krumholz, Harlan M.
背景：在最近降低心血管风险的努力中，美国老年患者急性心肌梗死（AMI）的发生率是否有所下降尚不清楚。方法和结果：通过使用2002年至2007年医疗保险和医疗补助服务中心的数据，确定了在美国住院的主要出院诊断为AMI的医疗保险按服务收费的患者，选择这一时间段是为了减少AMI新定义引起的变化。医疗保险受益人分母文件用于确定风险人群。使用泊松回归分析每年计算每10万受益年的AMI住院率，并根据年龄、性别和种族分层。按服务收费的医疗保险人口的急性心肌梗塞住院率从2002年的每10万受益年1131人下降到2007年的866人，相对下降了23.4%。在对年龄、性别和种族进行调整后，急性心肌梗死住院率下降了5.8%/年。从2002年到2007年，白人男性AMI住院率下降24.4%，而黑人男性AMI住院率下降幅度较小(18.0%；P
Background-Amid recent efforts to reduce cardiovascular risk, whether rates of acute myocardial infarction (AMI) in the United States have declined for elderly patients is unknown.Methods and Results-Medicare fee-for-service patients hospitalized in the United States with a principal discharge diagnosis of AMI were identified through the use of data from the Centers for Medicare and Medicaid Services from 2002 to 2007, a time period selected to reduce changes arising from the new definition of AMI. The Medicare beneficiary denominator file was used to determine the population at risk. AMI hospitalization rates were calculated annually per 100 000 beneficiary-years with Poisson regression analysis and stratified according to age, sex, and race. The annual AMI hospitalization rate in the fee-for-service Medicare population fell from 1131 per 100 000 beneficiary-years in 2002 to 866 in 2007, a relative 23.4% decline. After adjustment for age, sex, and race, the AMI hospitalization rate declined by 5.8%/y. From 2002 to 2007, white men experienced a 24.4% decrease in AMI hospitalizations, whereas black men experienced a smaller decline (18.0%; P