The association between on-site cardiac catheterization facilities and the use of coronary angiography after acute myocardial infarction

Article Abstract:

Patients treated in hospitals with cardiac catheterization facilities were three times more likely to have coronary angiography performed after a heart attack than patients admitted to a hospital without those facilities. Coronary angiography is a diagnostic technique that uses X-rays to visualize the heart and blood vessels after the injection of a contrast medium into the veins. A review of the records of 5,867 patients admitted to 19 Seattle, WA, hospitals for treatment of heart attacks evaluated the likelihood that patients would have angiography performed. A further analysis of 614 patients treated by doctors who worked at both hospitals with the catheterization facilities and those without indicated that the doctors performed the procedure on 73% of their patients at hospitals with on-site facilities. The procedure was only performed on 47% of those admitted to hospitals without cardiac catheterization facilities. There was no association between on-site facilities and in-hospital mortality rates.

Equipment and supplies, Angiography, Cardiac catheterization, Heart catheterization

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A comparison of thrombolytic therapy with primary coronary angioplasty for acute myocardial infarction

Article Abstract:

Treatment of acute heart attack with clot-dissolving drugs or angioplasty appears to be equally effective. Angioplasty and drugs called thrombolytics are both used to open blocked arteries. Researchers studied short-term and long-term mortality in 1,050 heart attack patients treated with angioplasty and 2,095 heart attack patients treated with thrombolytics. There was no difference in mortality between the groups in the short- or long-term. Those who received angioplasty used more resources and incurred higher costs. Thrombolytics are easy to administer and do not require technical skill.

Evaluation, Transluminal angioplasty, Balloon angioplasty, Thrombolytic therapy

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Absence of association between insurance copayments and delays in seeking emergency care among patients with myocardial infarction

Article Abstract:

Having to make a copayment may not necessarily reduce the use of emergency medical services. Researchers analyzed the hospital records of 1,331 people in an HMO who came to the emergency room with the signs and symptoms of a heart attack. Of these, 602 were required to make a copayment and 729 were not. A copayment requirement did not cause any significant delays in seeking medical care even after adjusting for other factors that might influence emergency room visits. Some studies have shown that copayment requirements lead to reduced use of emergency medical services.

Analysis, Emergency medical services, Health insurance

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