TY - JOUR
T1 - Influence of insurance type on the use of procedures, medications and hospital outcome in patients with unstable angina
T2 - Results from the GUARANTEE Registry
AU - Every, Nathan R.
AU - Cannon, Christopher P.
AU - Granger, Christopher
AU - Moliterno, David J.
AU - Aguirre, Frank V.
AU - Talley, J. David
AU - Booth, Joan
AU - Sapp, Shelly
AU - Ferguson, James J.
N1 - Funding Information:
This research was supported by a grant from The Department of Veterans Affairs (HSR&D Cancer Development Award) and Eli Lilly & Co of Indianapolis, Indiana.
PY - 1998/8
Y1 - 1998/8
N2 - Objectives. The purpose of this study was to investigate whether or not there is an association between managed care insurance and the delivery and outcome of care in patients presenting with unstable angina. Background. The proportion of U.S. patients with managed care health insurance is increasing. This may be associated with recent improvements in the control of health care costs. It is unknown whether or not there is a difference in process of care in angina patients presenting with managed care versus fee-for-service health insurance. Methods. We compared baseline characteristics, process and outcome of care in 636 patients with managed care insurance (MC) and 1,404 patients with fee-for-service (FFS) insurance who presented with unstable angina to 35 hospitals participating in the global Unstable Augina Registry and Treatment Evaluation (GUARANTEE) Registry. Results. Although, there was little difference in baseline characteristics and hospital treatments between cohorts, MC patients were more likely to be discharged on guideline- recommended medications (aspirin and beta-adrenergic blocking agents). In addition, FFS patients were more likely to undergo cardiac catheterization (odds ratio = 1.25 95% confidence interval = 1.1 to 1.5), but not revascularization during the hospitalization. There was no difference in hospital mortality (0.9% versus 1.2% in MC versus FFS; p = 0.60). Conclusions. In patients admitted with suspected unstable angina, MC patients are less likely to undergo coronary angiography, but are more likely to be discharged on indicated medications.
AB - Objectives. The purpose of this study was to investigate whether or not there is an association between managed care insurance and the delivery and outcome of care in patients presenting with unstable angina. Background. The proportion of U.S. patients with managed care health insurance is increasing. This may be associated with recent improvements in the control of health care costs. It is unknown whether or not there is a difference in process of care in angina patients presenting with managed care versus fee-for-service health insurance. Methods. We compared baseline characteristics, process and outcome of care in 636 patients with managed care insurance (MC) and 1,404 patients with fee-for-service (FFS) insurance who presented with unstable angina to 35 hospitals participating in the global Unstable Augina Registry and Treatment Evaluation (GUARANTEE) Registry. Results. Although, there was little difference in baseline characteristics and hospital treatments between cohorts, MC patients were more likely to be discharged on guideline- recommended medications (aspirin and beta-adrenergic blocking agents). In addition, FFS patients were more likely to undergo cardiac catheterization (odds ratio = 1.25 95% confidence interval = 1.1 to 1.5), but not revascularization during the hospitalization. There was no difference in hospital mortality (0.9% versus 1.2% in MC versus FFS; p = 0.60). Conclusions. In patients admitted with suspected unstable angina, MC patients are less likely to undergo coronary angiography, but are more likely to be discharged on indicated medications.
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U2 - 10.1016/S0735-1097(98)00254-X
DO - 10.1016/S0735-1097(98)00254-X
M3 - Article
C2 - 9708465
AN - SCOPUS:0032145673
SN - 0735-1097
VL - 32
SP - 387
EP - 392
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 2
ER -