Association of Statewide Certificate of Need Regulations With Percutaneous Coronary Intervention Appropriateness and Outcomes.
| Title: | Association of Statewide Certificate of Need Regulations With Percutaneous Coronary Intervention Appropriateness and Outcomes. |
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| Authors: | Chui PW; 1 Section of Internal Medicine VA Connecticut Healthcare System West Haven CT.; 3 Department of Internal Medicine Yale University School of Medicine New Haven CT.; Parzynski CS; 2 Center for Outcomes Research and Evaluation Yale-New Haven Hospital New Haven CT.; Ross JS; 2 Center for Outcomes Research and Evaluation Yale-New Haven Hospital New Haven CT.; 3 Department of Internal Medicine Yale University School of Medicine New Haven CT.; Desai NR; 2 Center for Outcomes Research and Evaluation Yale-New Haven Hospital New Haven CT.; 8 Section of Cardiovascular Medicine Department of Internal Medicine Yale University School of Medicine New Haven CT.; Gurm HS; 4 Division of Cardiovascular Medicine University of Michigan Medical School Ann Arbor MI.; Spertus JA; 5 Saint Luke's Mid America Heart Institute/University of Missouri Kansas City Kansas City MO.; Seto AH; 6 Department of Medicine VA Long Beach Health Care System Long Beach CA.; Ho V; 7 Baker Institute for Public Policy Rice University Houston TX.; Curtis JP; 2 Center for Outcomes Research and Evaluation Yale-New Haven Hospital New Haven CT.; 8 Section of Cardiovascular Medicine Department of Internal Medicine Yale University School of Medicine New Haven CT. |
| Source: | Journal of the American Heart Association [J Am Heart Assoc] 2019 Jan 22; Vol. 8 (2), pp. e010373. |
| Publication Type: | Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
| Language: | English |
| Journal Info: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford : Wiley-Blackwell |
| MeSH Terms: | Hospitals* ; Patient Selection* ; Quality Assurance, Health Care* ; Registries*; Certificate of Need/*statistics & numerical data ; Coronary Artery Disease/*surgery ; Percutaneous Coronary Intervention/*legislation & jurisprudence; Aged ; Cross-Sectional Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; United States |
| Abstract: | Background Certificate of need ( CON ) regulations are intended to coordinate new healthcare services, limit expansion of unnecessary new infrastructure, and limit healthcare costs. However, there is limited information about the association of CON regulations with the appropriateness and outcomes of percutaneous coronary interventions ( PCI ). The study sought to characterize the association between state CON regulations and PCI appropriateness. Methods and Results We used data from the American College of Cardiology's Cath PCI Registry to analyze 1 268 554 PCI s performed at 1297 hospitals between January 2010 and December 2011. We used the Appropriate Use Criteria to classify PCI procedures as appropriate, maybe appropriate, or rarely appropriate and used Chi-square analyses to assess whether the proportions of PCI s in each Appropriate Use Criteria category varied depending on whether the procedure had been performed in a state with or without CON regulations. Analyses were repeated stratified by whether or not the procedure had been performed in the setting of an acute coronary syndrome ( ACS ). Among 1 268 554 PCI procedures, 674 384 (53.2%) were performed within 26 CON states. The proportion of PCI s classified as rarely appropriate in CON states was slightly lower compared with non- CON states (3.7% versus 4.0%, P |
| Comments: | Comment in: J Am Heart Assoc. 2019 Jan 22;8(2):e011661. doi: 10.1161/JAHA.118.011661.. (PMID: 30642213) |
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| Grant Information: | K12 HS023000 United States HS AHRQ HHS |
| Contributed Indexing: | Keywords: appropriateness criteria; outcomes research; percutaneous coronary intervention |
| Entry Date(s): | Date Created: 20190116 Date Completed: 20200103 Latest Revision: 20260304 |
| Update Code: | 20260304 |
| PubMed Central ID: | PMC6497347 |
| DOI: | 10.1161/JAHA.118.010373 |
| PMID: | 30642222 |
| Database: | MEDLINE |
Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.