Abstract 11150: Trends in Coronary Revascularization Procedures among Medicare Beneficiaries Between Fiscal Years 2008 and 2011
Background: This study reports trends among Medicare beneficiaries (MB) in the volume of coronary revascularization procedures (CRP) and observed mortality rates between fiscal years 2008 and 2011.
Methods: This retrospective study examined both the Medicare Provider Analysis and Review (MedPar) Files and the Medicare Outpatient File to identify all MB undergoing a CRP; either coronary bypass graft (CABG) surgery or percutaneous coronary intervention (PCI). The study population consists of 2,235,971 MBs undergoing one or more CRPs. ICD-9 procedure codes were used to identify procedures: PCI only, CABG only, both PCI and CABG, CABG plus valve surgery, PCI plus valve surgery, and PCI, CABG, and valve surgery. Discharge status was used to calculated mortality rates by type of procedure.
Results: During the four year study period, the annual number of CRPs decreased from 563,744 (FY-2008) to 546,092 (FY-2011); a compounded annual rate of decline of 1.07% per year. The number of CRP procedures per 1,000 MBs decreased from 12.6 in FY-2008 to 11.5 in FY-2011 both due to the decline in the number of procedures and the increase in the number of MBs. There was a significant change in the admission status of PCI only procedures over the study period; 48,659 more outpatient PCIs but 54,402 fewer inpatient PCIs in FY-2011 than in FY-2008, but only a net decline of 5,743 procedures. The total number of CABG surgeries declined by 2.9% per year over the 4-year study period. During the study period, mortality rates decline from their 2008 levels for the major CRP groups, except for inpatient PCI which increased from 1.89% to 2.38%.
Conclusions: The overall volume of CRPs among MBs is declining, especially if one tracks the number of CRPs per 1,000 MBs. While, the admission status and combination of CRPs being performed is varying, the overall observed mortality rate for all CRPs performed on the Medicare populations has remained relatively stable between 2.14% and 2.18% per year.
- © 2013 by American Heart Association, Inc.