Veterans undergoing elective PCI at community hospitals may have increased chance of death compared to those treated at VA hospitals

August 24, 2020

Veterans who underwent elective percutaneous coronary intervention (PCI) for stable angina at a community facility were at a 33% increased hazard, or chance, of death compared to patients treated within the Veterans Affairs (VA) Healthcare System, according to an analysis of nearly 9,000 veterans published today in the Journal of the American College of Cardiology.

Due to patient access concerns, the VA Healthcare System has expanded clinical care outside of the integrated system through a community care program that enables veterans to receive care from non-federal facilities. Facilities in the community care program range from academic medical centers to rural safety net hospitals, and since the community care program does not restrict access based on procedural volumes or quality, patients may choose facilities with differing levels of expertise.

According to the analysis, the utilization of community facilities for elective PCI has increased over 50% in the last three years. Overall, treatment in the community was associated with worse outcomes, including a 33% increased hazard of death within the first year after intervention and a 143% increased hazard of death within the first month.

"A larger proportion of Veterans are undergoing elective coronary intervention for stable angina in community facilities, a trend that will likely continue with the recent adoption of the MISSION ACT. The community facilities that provide care to these patients are heterogeneous, and the data available for quality assessment is largely limited to billing records," said Stephen W. Waldo, MD, National Director of the VA Clinical Assessment, Reporting and Tracking (CART) Program and lead author of the study. "While these data may be limited, this analysis suggests that clinical outcomes for Veterans undergoing percutaneous coronary intervention in the community may diverge from those treated within the VA Healthcare System. Because of this, we must ensure that increased access to medical care in the community is accompanied by mechanisms to ensure similar levels of quality."

Limitations include data for the VA Healthcare System was derived from clinical documentation whereas administrative billing data was used for care provided in community facilities. The limited data available on patients treated in community facilities means it is possible that more complex procedures were performed in that setting.

The researchers concluded that further study is needed to determine the most effective means to improves veterans' access to medical care while also maintaining quality.
-end-
The American College of Cardiology envisions a world where innovation and knowledge optimize cardiovascular care and outcomes. As the professional home for the entire cardiovascular care team, the mission of the College and its 54,000 members is to transform cardiovascular care and to improve heart health. The ACC bestows credentials upon cardiovascular professionals who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. The College also provides professional medical education, disseminates cardiovascular research through its world-renowned JACC Journals, operates national registries to measure and improve care, and offers cardiovascular accreditation to hospitals and institutions. For more, visit acc.org.The Journal of the American College of Cardiology ranks among the top cardiovascular journals in the world for its scientific impact. JACC is the flagship for a family of journals--JACC: Cardiovascular Interventions, JACC: Cardiovascular Imaging, JACC: Heart Failure, JACC: Clinical Electrophysiology, JACC: Basic to Translational Science, JACC: Case Reports and JACC: CardioOncology--that prides themselves in publishing the top peer-reviewed research on all aspects of cardiovascular disease. Learn more at JACC.org.

American College of Cardiology

Related Data Articles from Brightsurf:

Keep the data coming
A continuous data supply ensures data-intensive simulations can run at maximum speed.

Astronomers are bulging with data
For the first time, over 250 million stars in our galaxy's bulge have been surveyed in near-ultraviolet, optical, and near-infrared light, opening the door for astronomers to reexamine key questions about the Milky Way's formation and history.

Novel method for measuring spatial dependencies turns less data into more data
Researcher makes 'little data' act big through, the application of mathematical techniques normally used for time-series, to spatial processes.

Ups and downs in COVID-19 data may be caused by data reporting practices
As data accumulates on COVID-19 cases and deaths, researchers have observed patterns of peaks and valleys that repeat on a near-weekly basis.

Data centers use less energy than you think
Using the most detailed model to date of global data center energy use, researchers found that massive efficiency gains by data centers have kept energy use roughly flat over the past decade.

Storing data in music
Researchers at ETH Zurich have developed a technique for embedding data in music and transmitting it to a smartphone.

Life data economics: calling for new models to assess the value of human data
After the collapse of the blockchain bubble a number of research organisations are developing platforms to enable individual ownership of life data and establish the data valuation and pricing models.

Geoscience data group urges all scientific disciplines to make data open and accessible
Institutions, science funders, data repositories, publishers, researchers and scientific societies from all scientific disciplines must work together to ensure all scientific data are easy to find, access and use, according to a new commentary in Nature by members of the Enabling FAIR Data Steering Committee.

Democratizing data science
MIT researchers are hoping to advance the democratization of data science with a new tool for nonstatisticians that automatically generates models for analyzing raw data.

Getting the most out of atmospheric data analysis
An international team including researchers from Kanazawa University used a new approach to analyze an atmospheric data set spanning 18 years for the investigation of new-particle formation.

Read More: Data News and Data Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.