Health Care Financing Review

Title
Swan-Ganz catheter use and mortality of myocardial infarction patients.
First Author
Blumberg, Mark S
Date of Pub
1994 Summer
Pages
91-103
Volume
15
Issue
4
Other Authors
Binns, Gregory S
Abstract
Using the 1989 Medicare provider analysis and review (MEDPAR) file, we calculated a 30-day indirectly standardized mortality ratio (SMR) for all "fresh" acute myocardial infarction (AMI) Medicare aged cases (i.e., fresh AMI patients are those who had not reported an AMI in the prior 8 weeks) at 2,900 hospitals, as well as an indirectly standardized procedure ratio (SPR) of Swan-Ganz catheter (SGC) use for these AMI cases at each hospital. Cases at hospitals with higher SGC SPRs also had higher SMRs. This positive association persisted when hospitals were further stratified by their annual volume of fresh AMI cases. We believe that our use of cases as the unit of observation, stratified by the SGC SPR of their hospital, avoids some case selection bias in observational studies directly comparing risk-adjusted mortality of cases with and without SGC.
Abstract Continued
N/A
MeSH
Hospital Mortality : Aged : Catheterization, Swan-Ganz/statistics & numerical data/utilization : Data Collection : Evaluation Studies : Human : Least-Squares Analysis : Logistic Models : Medicare/utilization : Myocardial Infarction/mortality/surgery : Treatment Outcome : United States/epidemiology
NTIS Number
PB99-106437