The Association of Payer With Utilization of Cardiac Procedures in Massachusetts
Wenneker, Mark B.
Weissman, Joel S.
Epstein, Arnold M.
JAMA. 1990 Sep 12; 264(10): 1255-1260.
This study evaluated the effect of insurance status on the utilization of three widely used and expensive cardiac procedures: coronary angiography, bypass grafting, and angioplasty. Data were obtained from records for all patients with circulatory disorders who were discharged from nonfederal acute care hospitals in Massachusetts during 1985. Analysis of the data revealed that unadjusted procedure rates for privately insured patients were approximately twice the rates for Medicaid and uninsured patients. The latter two groups of cardiac patients underwent procedures at about the same rate. Wenneker, et al. discuss possible reasons for the differences in utilization of cardiac procedures among the three groups of patients. They conclude that their findings raise serious questions about the quality of care for patients with heart disease in the context of payer status, and that further study of the issue is needed. (KIE abstract)
Diagnosis; Disease; Economics; Evaluation; Evaluation Studies; Financial Support; Health; Health Care; Health Care Delivery; Health Insurance; Heart Diseases; Hospitals; Indigents; Insurance; Patient Care; Patients; Physicians; Public Policy; Records; Remuneration; Selection for Treatment; Socioeconomic Factors; Statistics; Surgery;
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Racial Inequalities in the Use of Procedures for Patients With Ischemic Heart Disease in Massachusetts Wenneker, Mark B.; Epstein, Arnold M. (1988-01-13)The authors examined all admissions for circulatory diseases or chest pain to Massachusetts hospitals in 1985 for indications of interracial differences in the utilization of coronary angiography, coronary artery ...