Abstract
We sought to examine the effect of insurance type upon the likelihood of receiving a drug-eluting stent (DES). Recent guidelines suggest that consideration of a patient's resources should play a role in decisions to use DES. Previous studies have also documented disparities in both access to care and cardiovascular outcomes according to race, insurance, and socioeconomic status. The effect of insurance status upon the decision to use DES is unclear. Patients undergoing percutaneous coronary intervention (PCI) with stenting from April 2003 to June 2009, the so-called DES era, were retrospectively analyzed. Multivariable logistic regression was performed separately for patients <65 years and patients > or =65 years, with receipt of > or =1 DES during PCI as the outcome variable of interest. Insurance type was categorized as private, Medicare, Medicaid, and uninsured, based upon the primary insurance at discharge. Data regarding duration of clopidogrel therapy at 1 month, 6 months, and 1 year was also collected. Among the 12,584 patients who underwent PCI with stenting, 6,157 (48.9%) had private insurance, 5,689 (45.2%) had Medicare, 467 (3.7%) had Medicaid, and 271 (2.2%) were uninsured at the time of hospital discharge. There we...Continue Reading
References
Jan 16, 1991·JAMA : the Journal of the American Medical Association·J HadleyJ Feder
Sep 12, 1990·JAMA : the Journal of the American Medical Association·M B WennekerA M Epstein
Sep 12, 1996·The New England Journal of Medicine·M E GornickB C Vladeck
May 1, 1997·Journal of General Internal Medicine·J WhittleM Joswiak
Jun 17, 1998·Journal of the American College of Cardiology·M J SadaW J Rogers
Aug 26, 1998·Journal of the American College of Cardiology·N R EveryJ J Ferguson
Sep 24, 1999·Clinical Cardiology·J G CantoN C Chandra
Mar 29, 2000·Archives of Internal Medicine·J G CantoH V Barron
May 16, 2000·Archives of Internal Medicine·J ConigliaroD S Macpherson
Apr 9, 2001·American Journal of Public Health·M SoobaderB Maury
Sep 1, 2001·Annals of Internal Medicine·N R Kressin, L A Petersen
Jul 2, 2003·Circulation·Peter W GroeneveldAlan M Garber
Apr 14, 2004·Circulation·Allen JeremiasJoseph P Carrozza
May 5, 2005·JAMA : the Journal of the American Medical Association·Ioannis IakovouAntonio Colombo
May 4, 2006·JAMA : the Journal of the American Medical Association·Joseph S RossSusan H Busch
Jun 14, 2006·Circulation·John A SpertusDavid J Cohen
Jul 4, 2006·Journal of the American College of Cardiology·Michael JonerRenu Virmani
Jul 25, 2006·The American Journal of Cardiology·Duk-Woo ParkSeung-Jung Park
Aug 1, 2006·American Heart Journal·Sunil V RaoEric D Peterson
Nov 23, 2006·Annals of Internal Medicine·James E CalvinEric D Peterson
Dec 19, 2006·Journal of the American College of Cardiology·Matthias PfistererUNKNOWN BASKET-LATE Investigators
Jan 17, 2007·Circulation·Cindy L GrinesUNKNOWN American College of Physicians
Feb 14, 2007·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Cindy L GrinesUNKNOWN American College of Physicians
Feb 14, 2007·The New England Journal of Medicine·Laura MauriDonald E Cutlip
Feb 14, 2007·The New England Journal of Medicine·Bo LagerqvistUNKNOWN SCAAR Study Group
Feb 14, 2007·The New England Journal of Medicine·Adnan KastratiAlbert Schömig
Feb 14, 2007·The New England Journal of Medicine·Gregg W StoneMartin B Leon
Jul 3, 2007·American Indian and Alaska Native Mental Health Research : the Journal of the National Center·Ernest MoyRoxanne Andrews
Aug 8, 2007·Annals of Internal Medicine·Joseph S Ross
Dec 15, 2007·Circulation·Spencer B KingClyde W Yancy
Jan 15, 2008·Journal of the American College of Cardiology·Spencer B KingClyde W Yancy
Nov 27, 2008·American Heart Journal·John KaoJohn A Spertus
Jun 17, 2009·Circulation·Ajay J KirtaneGregg W Stone
Citations
Jul 24, 2010·JACC. Cardiovascular Interventions·Ronald J Krone
Dec 15, 2011·Medical Care·Andrew J EpsteinPeter W Groeneveld
Sep 17, 2013·PloS One·Cynthia A BeckWilliam A Ghali
Dec 3, 2014·The American Journal of Cardiology·Apurva O BadhekaTheodore Schreiber
May 15, 2016·The Canadian Journal of Cardiology·Edward L HannanSpencer B King
May 28, 2013·American Heart Journal·Sherezade KhambattaHitinder S Gurm
Nov 28, 2012·The Spine Journal : Official Journal of the North American Spine Society·Miriam NuñoFrank L Acosta
Jun 3, 2015·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Sidakpal S PanaichCindy Grines
Sep 20, 2012·Journal of Interventional Cardiology·Wayne B BatchelorPaul L Underwood
May 7, 2014·Clinical Cardiology·Matthew J CzarnyLaura Mauri
Apr 23, 2016·The American Journal of Cardiology·Vikas SinghAbhijit Ghatak
Dec 28, 2010·The American Journal of Cardiology·Michael A GagliaRon Waksman
Jun 25, 2015·Cardiology Research and Practice·Jose F ChavezAtman P Shah
Jan 15, 2011·Journal of the American College of Cardiology·Clyde W YancyUNKNOWN credo Advisory Group
May 13, 2014·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Michael A GagliaLeonardo Clavijo
Sep 21, 2016·The American Journal of Cardiology·Mi Hee ChoHyun Kyoung Kim
Mar 17, 2017·Clinical Cardiology·Ali ShafiqAdam C Salisbury
Jul 20, 2012·Circulation. Cardiovascular Quality and Outcomes·Purav ModyKumar Dharmarajan
May 17, 2012·Circulation·Tajinder P SinghDionne A Graham
Jan 5, 2019·Circulation. Cardiovascular Quality and Outcomes·Nirav PatelPankaj Arora
Jun 17, 2020·Journal of Women's Health·Mohammed Imran GhareAlexandra Lansky
Jun 11, 2019·BioMed Research International·Ngoc Minh LuuVan Huy Nguyen
Jan 8, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Daniel A FeldmanAmer K Ardati
Jun 9, 2017·PloS One·Raymond N KuoMei-Shu Lai