Impact of insurance status on ICD implantation practice patterns: Insights from the NCDR ICD registry.
| Title: | Impact of insurance status on ICD implantation practice patterns: Insights from the NCDR ICD registry. |
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| Authors: | Ahmed I; Internal Medicine/Cardiology, Yale School of Medicine, New Haven, CT.; Merchant FM; Section of Cardiac Electrophysiology, Emory University School of Medicine, Atlanta, GA.; Curtis JP; Internal Medicine/Cardiology, Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation; Yale School of Medicine; New Haven, CT.; Parzynski CS; Center for Outcomes Research and Evaluation; Yale School of Medicine; New Haven, CT.; Lampert R; Internal Medicine/Cardiology, Yale School of Medicine, New Haven, CT. Electronic address: rachel.lampert@yale.edu. |
| Source: | American heart journal [Am Heart J] 2021 May; Vol. 235, pp. 44-53. Date of Electronic Publication: 2021 Jan 24. |
| Publication Type: | Journal Article; Multicenter Study |
| Language: | English |
| Journal Info: | Publisher: Mosby Country of Publication: United States NLM ID: 0370465 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6744 (Electronic) Linking ISSN: 00028703 NLM ISO Abbreviation: Am Heart J Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: St. Louis, MO : Mosby |
| MeSH Terms: | Registries*; Death, Sudden, Cardiac/*prevention & control ; Defibrillators, Implantable/*economics ; Heart Failure/*therapy ; Insurance Coverage/*economics ; Primary Prevention/*methods; Heart Failure/economics ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies |
| Abstract: | Background: Whether insurance status influences practice patterns in implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy (CRT) defibrillators, when indicated, is not known.; Methods and Results: We analyzed the NCDR ICD Registry to evaluate associations of insurance status with guidelines-based receipt of CRT, as well as device-type, complication rates, and use of optimal medical therapy defined by guidelines. Among 798,028 patients with de novo ICD implants, we included only patients < 65 years (those older have Medicare) and excluded those admitted before 2006 (n=1,835) or with insurance coverage other than Medicare, Medicaid or private insurance (n=25,695) leaving 286,556 for analysis. Inverse probability of treatment weighting was used to control for imbalances between groups. Mean age was 53 years, 29% were female. Patients with private insurance and Medicare were more likely to receive CRT-D when indicated (79.6%, OR 1.19 95% CI 1.09-1.28, P |
| Entry Date(s): | Date Created: 20210127 Date Completed: 20210824 Latest Revision: 20210824 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.ahj.2021.01.016 |
| PMID: | 33503408 |
| Database: | MEDLINE |
Journal Article; Multicenter Study