Hospital-level variation in follow-up strategies after percutaneous coronary intervention, revealed in health claims data of Korea

Abstract This study sought to determine hospital variation in the use of follow-up stress testing (FUST) and invasive coronary angiography (FUCAG) after percutaneous coronary intervention (PCI). The claims records of 150,580 Korean patients who received PCI in 128 hospitals between 2008 and 2015 wer...

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Autores principales:	Jae-Hyung Roh, Jihyun Sohn, Jae-Hwan Lee, In-Sun Kwon, Hanbyul Lee, Yong-Hoon Yoon, Minsu Kim, Yong-Giun Kim, Gyung-Min Park, Jong-Young Lee, Jae-Hyeong Park, Dong Heon Yang, Hun Sik Park
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a99a71d356e34cb486aba339478b1dea
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spelling	oai:doaj.org-article:a99a71d356e34cb486aba339478b1dea2021-12-02T14:11:28ZHospital-level variation in follow-up strategies after percutaneous coronary intervention, revealed in health claims data of Korea10.1038/s41598-021-82960-42045-2322https://doaj.org/article/a99a71d356e34cb486aba339478b1dea2021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-82960-4https://doaj.org/toc/2045-2322Abstract This study sought to determine hospital variation in the use of follow-up stress testing (FUST) and invasive coronary angiography (FUCAG) after percutaneous coronary intervention (PCI). The claims records of 150,580 Korean patients who received PCI in 128 hospitals between 2008 and 2015 were analyzed. Patient were considered to have undergone FUST and FUCAG, when these testings were performed within two years after discharge from the index hospitalization. Hierarchical generalized linear and frailty models were used to evaluate binary and time-to-event outcomes. Hospital-level risk-standardized FUCAG and FUST rates were highly variable across the hospitals (median, 0.41; interquartile range [IQR], 0.27–0.59; median, 0.22; IQR, 0.08–0.39, respectively). The performances of various models predicting the likelihood of FUCAG and FUST were compared, and the best performance was observed with the models adjusted for patient case mix and individual hospital effects as random effects (receiver operating characteristic curves, 0.72 for FUCAG; 0.82 for FUST). The intraclass correlation coefficients of the models (0.41 and 0.68, respectively) indicated that a considerable proportion of the observed variation was related to individual institutional effects. Higher hospital-level FUCAG and FUST rates were not preventive of death or myocardial infarction. Increased repeat revascularizations were observed in hospitals with higher FUCAG rates.Jae-Hyung RohJihyun SohnJae-Hwan LeeIn-Sun KwonHanbyul LeeYong-Hoon YoonMinsu KimYong-Giun KimGyung-Min ParkJong-Young LeeJae-Hyeong ParkDong Heon YangHun Sik ParkNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jae-Hyung Roh Jihyun Sohn Jae-Hwan Lee In-Sun Kwon Hanbyul Lee Yong-Hoon Yoon Minsu Kim Yong-Giun Kim Gyung-Min Park Jong-Young Lee Jae-Hyeong Park Dong Heon Yang Hun Sik Park Hospital-level variation in follow-up strategies after percutaneous coronary intervention, revealed in health claims data of Korea
description	Abstract This study sought to determine hospital variation in the use of follow-up stress testing (FUST) and invasive coronary angiography (FUCAG) after percutaneous coronary intervention (PCI). The claims records of 150,580 Korean patients who received PCI in 128 hospitals between 2008 and 2015 were analyzed. Patient were considered to have undergone FUST and FUCAG, when these testings were performed within two years after discharge from the index hospitalization. Hierarchical generalized linear and frailty models were used to evaluate binary and time-to-event outcomes. Hospital-level risk-standardized FUCAG and FUST rates were highly variable across the hospitals (median, 0.41; interquartile range [IQR], 0.27–0.59; median, 0.22; IQR, 0.08–0.39, respectively). The performances of various models predicting the likelihood of FUCAG and FUST were compared, and the best performance was observed with the models adjusted for patient case mix and individual hospital effects as random effects (receiver operating characteristic curves, 0.72 for FUCAG; 0.82 for FUST). The intraclass correlation coefficients of the models (0.41 and 0.68, respectively) indicated that a considerable proportion of the observed variation was related to individual institutional effects. Higher hospital-level FUCAG and FUST rates were not preventive of death or myocardial infarction. Increased repeat revascularizations were observed in hospitals with higher FUCAG rates.
format	article
author	Jae-Hyung Roh Jihyun Sohn Jae-Hwan Lee In-Sun Kwon Hanbyul Lee Yong-Hoon Yoon Minsu Kim Yong-Giun Kim Gyung-Min Park Jong-Young Lee Jae-Hyeong Park Dong Heon Yang Hun Sik Park
author_facet	Jae-Hyung Roh Jihyun Sohn Jae-Hwan Lee In-Sun Kwon Hanbyul Lee Yong-Hoon Yoon Minsu Kim Yong-Giun Kim Gyung-Min Park Jong-Young Lee Jae-Hyeong Park Dong Heon Yang Hun Sik Park
author_sort	Jae-Hyung Roh
title	Hospital-level variation in follow-up strategies after percutaneous coronary intervention, revealed in health claims data of Korea
title_short	Hospital-level variation in follow-up strategies after percutaneous coronary intervention, revealed in health claims data of Korea
title_full	Hospital-level variation in follow-up strategies after percutaneous coronary intervention, revealed in health claims data of Korea
title_fullStr	Hospital-level variation in follow-up strategies after percutaneous coronary intervention, revealed in health claims data of Korea
title_full_unstemmed	Hospital-level variation in follow-up strategies after percutaneous coronary intervention, revealed in health claims data of Korea
title_sort	hospital-level variation in follow-up strategies after percutaneous coronary intervention, revealed in health claims data of korea
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/a99a71d356e34cb486aba339478b1dea
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Hospital-level variation in follow-up strategies after percutaneous coronary intervention, revealed in health claims data of Korea

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