Journal article
Declining mortality following acute myocardial infarction in the Department of Veterans Affairs Health Care System
BMC cardiovascular disorders, Vol.9(1), pp.44-44
08/31/2009
DOI: 10.1186/1471-2261-9-44
PMCID: PMC2746180
PMID: 19719849
Abstract
Background: Mortality from acute myocardial infarction (AMI) is declining worldwide. We sought to determine if mortality in the Veterans Health Administration (VHA) has also been declining.
Methods: We calculated 30-day mortality rates between 2004 and 2006 using data from the VHA External Peer Review Program (EPRP), which entails detailed abstraction of records of all patients with AMI. To compare trends within VHA with other systems of care, we estimated relative mortality rates between 2000 and 2005 for all males 65 years and older with a primary diagnosis of AMI using administrative data from the VHA Patient Treatment File and the Medicare Provider Analysis and Review (MedPAR) files.
Results: Using EPRP data on 11,609 patients, we observed a statistically significant decline in adjusted 30-day mortality following AMI in VHA from 16.3% in 2004 to 13.9% in 2006, a relative decrease of 15% and a decrease in the odds of dying of 10% per year (p = .011). Similar declines were found for in-hospital and 90-day mortality.Based on administrative data on 27,494 VHA patients age 65 years and older and 789,400 Medicare patients, 30-day mortality following AMI declined from 16.0% during 2000-2001 to 15.7% during 2004-June 2005 in VHA and from 16.7% to 15.5% in private sector hospitals. After adjusting for patient characteristics and hospital effects, the overall relative odds of death were similar for VHA and Medicare (odds ratio 1.02, 95% C.I. 0.96-1.08).
Conclusion: Mortality following AMI within VHA has declined significantly since 2003 at a rate that parallels that in Medicare-funded hospitals.
Details
- Title: Subtitle
- Declining mortality following acute myocardial infarction in the Department of Veterans Affairs Health Care System
- Creators
- Stephan D Fihn - VA Puget Sound Health Care System, Seattle, WA, USAMary Vaughan-Sarrazin - VA Medical Center, Iowa City and Department of Medicine, University of Iowa, Iowa City, IA, USAElliott Lowy - VA Puget Sound Health Care System, Seattle, WA, USAIoana Popescu - VA Medical Center, Iowa City and Department of Medicine, University of Iowa, Iowa City, IA, USACharles Maynard - VA Puget Sound Health Care System, Seattle, WA, USAGary E Rosenthal - VA Medical Center, Iowa City and Department of Medicine, University of Iowa, Iowa City, IA, USAAnne E Sales - University of Alberta, Edmonton, Alberta, CanadaJohn Rumsfeld - VA Medical Center, Denver, CO, USA; and Department of Medicine, University of Colorado, Denver, CO, USASandy Piñeros - VA Puget Sound Health Care System, Seattle, WA, USAMary B McDonell - VA Medical Center, Iowa City and Department of Medicine, University of Iowa, Iowa City, IA, USAChristian D Helfrich - VA Puget Sound Health Care System, Seattle, WA, USARoxane Rusch - Department of Veterans Affairs, Washington DC, USARobert Jesse - Department of Veterans Affairs, Washington DC, USAPeter Almenoff - Department of Veterans Affairs, Washington DC, USABarbara Fleming - Department of Veterans Affairs, Washington DC, USAMichael Kussman - Department of Veterans Affairs, Washington DC, USA
- Resource Type
- Journal article
- Publication Details
- BMC cardiovascular disorders, Vol.9(1), pp.44-44
- DOI
- 10.1186/1471-2261-9-44
- PMID
- 19719849
- PMCID
- PMC2746180
- NLM abbreviation
- BMC Cardiovasc Disord
- ISSN
- 1471-2261
- eISSN
- 1471-2261
- Publisher
- BioMed Central
- Language
- English
- Date published
- 08/31/2009
- Academic Unit
- Health Management and Policy; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984064186702771
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