Autor: |
Adam C Powell, Jason P Goldstein, James W Long, Jeffrey D Simmons, Anthony DeFrance |
Jazyk: |
angličtina |
Rok vydání: |
2022 |
Předmět: |
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Zdroj: |
PLoS ONE, Vol 17, Iss 4, p e0266544 (2022) |
Druh dokumentu: |
article |
ISSN: |
1932-6203 |
DOI: |
10.1371/journal.pone.0266544 |
Popis: |
ObjectivesTo examine whether the demographics of providers' prior year patient cohorts, providers' historic degree of catheter-based fractional flow reserve (FFR) utilization, and other provider characteristics were associated with post-catheterization performance of percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).Study designA retrospective, observational analysis of outpatient claims data was performed.MethodsAll 2018 outpatient catheterization claims from a national organization offering commercial and Medicare Advantage health plans were examined. Claims were excluded if the patient had a prior catheterization in 2018, had any indications of CABG or valvular heart disease in the prior year of claims, or if the provider had ≤10 catheterization claims in 2017. Downstream PCI and CABG were determined by examining claims 0-30 days post-catheterization. Using multivariate mixed effects logistic regression with provider identity random effects, the association between post-catheterization procedures and provider characteristics was assessed, controlling for patient characteristics.ResultsThe sample consisted of 31,920 catheterization claims pertaining to procedures performed by 964 providers. Among the catheterization claims, 8,554 (26.8%) were followed by PCI and 1,779 (5.6%) were followed by CABG. Catheterizations performed by providers with older prior year patient cohorts were associated with higher adjusted odds of PCI (1.78; CI: 1.26-2.53), even after controlling for patient age. Catheterizations performed by providers with greater historic use of FFR had significantly higher adjusted odds of being followed by PCI (1.73; CI: 1.26-2.37).ConclusionProvider characteristics may impact whether patients receive a procedure post-catheterization. Further research is needed to characterize this relationship. |
Databáze: |
Directory of Open Access Journals |
Externí odkaz: |
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