May 1, 2001Medical Care
Impact of Underuse, Overuse, and Discretionary Use on Geographic Variation in the Use of Coronary Angiography After Acute Myocardial Infarction
Why the study?
Does the use of coronary angiography after acute myocardial infarction vary across geographic regions based on appropriateness criteria?
Population
44,294 Medicare patients hospitalized with acute myocardial infarction during 1994 or 1995 across 95…
Design
Cohort
Authors
Discussion
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Member takes
Implication
May reflect discretionary use in appropriate cases; leaves open whether targeting uncertain indications reduces geographic variation.
Structured PICO
Does the use of coronary angiography after acute myocardial infarction vary across geographic regions based on appropriateness criteria?
P
Population
44,294 Medicare patients hospitalized with acute myocardial infarction (AMI) during 1994 or 1995 across 95 hospital referral regions
I
Intervention
Coronary angiography (assessed by appropriateness criteria: necessary; appropriate, but not necessary; uncertain; unsuitable)
O
Outcome
Variation in use of angiography, as measured by the difference between high and low rates of use across regions
Geographic variation in the overall use of coronary angiography after acute myocardial infarction is primarily driven by discretionary use rather than underuse or overuse.
Cite This Study
Guadagnoli et al. (2001) studied this question.