No pain, but no gain? The disappearance of angina hospitalizations, 1992-1999
UMass Chan Affiliations
Department of Family Medicine and Community HealthMeyers Primary Care Institute
Document Type
Journal ArticlePublication Date
2009-10-13Keywords
AgedAngina Pectoris
Data Collection
Female
Health Services Research
Hospitalization
Humans
Male
Medicare
Patient Discharge
Quality Indicators, Health Care
United States
Health Services Research
Primary Care
Metadata
Show full item recordAbstract
BACKGROUND: Hospitalization for angina is commonly considered an ambulatory care sensitive hospitalization and used as a measure of access to primary care. OBJECTIVE: To analyze time trends in angina-related hospitalizations and seek possible explanations for an observed, marked decline during 1992 to 1999. RESEARCH DESIGN: We analyzed Medicare claims of SEER-Medicare control subjects for occurrence of angina hospital discharges, using the Agency for Healthcare Research and Quality Prevention Quality Indicator (PQI) definition, along with occurrence of related events including angina admissions with revascularization, angina admissions discharged as coronary artery disease (CAD) or myocardial infarction, and overall ischemic heart disease discharges. SUBJECTS: Approximately 124,000 cancer-free Medicare beneficiary/ies, with subjects contributing data for 1 to 8 years. RESULTS: Angina PQI hospital discharges declined 75% between 1992 and 1999. CAD hospital discharges rose in a reciprocal pattern, while angina discharges with revascularization declined and discharges for myocardial infarction and ischemic heart disease were relatively constant during this time period. CONCLUSIONS: The marked decline in angina PQI hospital discharges during 1992-1999 does not appear to represent improvements in access to care or prevention of heart disease, but rather increased coding of more specific discharge diagnoses for CAD. Our findings suggest that angina hospitalization is not a valid measure for monitoring access to care and, more generally, demonstrate the need for careful, periodic re-evaluation of quality measures.Source
Med Care. 2009 Oct;47(10):1106-10. Link to article on publisher's siteDOI
10.1097/MLR.0b013e31819e1f53Permanent Link to this Item
http://hdl.handle.net/20.500.14038/37078PubMed ID
19820615Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1097/MLR.0b013e31819e1f53