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No Pain, But No Gain? The Disappearance of Angina Hospitalizations, 1992–1999

Bibliographic Data

ID9103353
AuthorsBarry G Saver (University of Massachusetts Chan Medical School, corresponding author), Sharon A Dobie (University of Washington), Pamela K Green (University of Washington), Ching-Yun Wang (Fred Hutch Cancer Center), Laura-Mae Baldwin, Laura Baldwin (University of Washington)
Year2009
Volume47
Issue10
Pages1106-1110
Publication date2009-10-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e31819e1f53
PMID19820615
PMCIDPMC2761607
OpenAlexW1998531243
LanguageEN
Citations received1
References cited6

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

Ambulatory · Angina · Cardiology · Coronary artery disease · Health care · Hospital discharge · Myocardial infarction · Physical therapy · Revascularization · Unstable angina · Acute Myocardial Infarction Research · Emergency Medicine · Healthcare Policy and Management · Internal Medicine · Medicine · Primary Care and Health Outcomes

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Unique citing works1
Citations per year0,17
Citation span2020 - 2020 (1)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 1

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