| Clinical and economic outcomes of percutaneous coronary interventions in the elderly: an analysis of medicare claims data. | |
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MedLine Citation:
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PMID: 15226211 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Outcomes after percutaneous coronary intervention (PCI) have been documented extensively in clinical trials and single-center series, but few data exist on the clinical and economic outcomes after PCI in an unselected population. METHODS AND RESULTS: We used the Medicare Standard Analytic File to identify all initial PCI procedures performed in 1998 among a random sample of 5% of all Medicare beneficiaries > or =65 years of age. These patients (n=9868) were followed up for 1 year after PCI to identify clinical outcomes, medical resource use, and costs. Between 1 month and 1 year after PCI, 16.9% of patients required > or =1 repeat revascularization procedures. Mean 1-year medical care costs increased 5-fold among patients with repeat revascularization compared with those without (26,186 dollars versus 5344 dollars; P<0.001). After adjustment for baseline differences, the independent cost of repeat revascularization was 19,074 dollars (95% CI, 18,440 to 19,707). Assuming from previous studies that 85% of repeat revascularization procedures over the first year of follow-up are attributable to restenosis, the estimated clinical restenosis rate was 14.4%, and the 1-year economic burden of restenosis to the healthcare system was 2747 dollars per initial PCI procedure. CONCLUSIONS: Among unselected elderly patients undergoing PCI, repeat revascularization occurs in approximately 14% and increases 1-year healthcare costs by >19,000 dollars per occurrence. These findings have important implications for the cost-effectiveness of new treatments that substantially reduce restenosis. |
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Authors:
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Mary Ann Clark; Ameet Bakhai; Michael J Lacey; Elise M Pelletier; David J Cohen |
Publication Detail:
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Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't Date: 2004-06-28 |
Journal Detail:
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Title: Circulation Volume: 110 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2004 Jul |
Date Detail:
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Created Date: 2004-07-20 Completed Date: 2004-12-14 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 259-64 Citation Subset: AIM; IM |
Affiliation:
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Department of Health Economics and Outcomes Research, Boston Scientific Corporation, Natick, Mass, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary Coronary Restenosis / economics*, epidemiology, prevention & control Cost-Benefit Analysis Female Humans Male Medicare Myocardial Revascularization* / economics* Reoperation Stents Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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