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Geographic Variation in Use of Cardiovascular Procedures

Geographic Variation in Use of Cardiovascular Procedures

Similar geographic variation seen for Medicare Advantage, Medicare fee-for-service beneficiaries

TUESDAY, July 9 (HealthDay News) -- There is considerable geographic variation in the use of cardiovascular procedures among Medicare Advantage beneficiaries and Medicare fee-for-service (FFS) beneficiaries, according to a study published in the July 10 issue of the Journal of the American Medical Association.

Daniel D. Matlock, M.D., M.P.H., from the University of Colorado Denver School of Medicine in Aurora, and colleagues conducted a cross-sectional study of Medicare beneficiaries older than 65 years to compare regional cardiovascular procedure rates between 878,339 Medicare Advantage and 5,013,650 Medicare FFS beneficiaries.

The researchers found that the adjusted procedure rates per 1,000 person-years were significantly lower for angiography and percutaneous coronary intervention (PCI), but were similar for coronary artery bypass (CABG) surgery, for Medicare Advantage versus Medicare FFS patients. No significant differences were seen between the Medicare groups in the rates of urgent angiography. Across hospital referral regions, there was considerable variation in procedure rates among Medicare Advantage and Medicare FFS patients. For angiography, for Medicare Advantage beneficiaries, the rates per 1,000 person-years varied from 9.8 to 40.6, compared with 15.7 to 44.3 for Medicare FFS beneficiaries. For PCI, the rates varied from 3.5 to 16.8 and from 4.7 to 16.1, respectively, while for CABG surgery the rates varied from 1.5 to 6.1 and from 2.5 to 6.0, respectively. Across regions, for angiography there was no significant correlation between Medicare Advantage and Medicare FFS beneficiary utilization, while modest correlations were seen for PCI and CABG.

"The degree of geographic variation in procedure rates was substantial among Medicare Advantage beneficiaries and was similar in magnitude to that observed among Medicare FFS beneficiaries," the authors write.

A financial tie was disclosed between one institution and EpiSource.

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