Insurance type influences the use of drug-eluting stents

JACC. Cardiovascular Interventions
Michael A GagliaRon Waksman

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

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Citations

Jul 24, 2010·JACC. Cardiovascular Interventions·Ronald J Krone
Dec 15, 2011·Medical Care·Andrew J EpsteinPeter W Groeneveld
Dec 3, 2014·The American Journal of Cardiology·Apurva O BadhekaTheodore Schreiber
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Dec 28, 2010·The American Journal of Cardiology·Michael A GagliaRon Waksman
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