Coronary angiography and coronary artery revascularisation rates in public and private hospital patients after acute myocardial infarction.
OBJECTIVE
To determine the rates of coronary angiography or coronary artery revascularisation procedures in patients with acute myocardial infarction (AMI) managed in private versus public hospitals.


METHODS
Case record linkage analysis of data from the Victorian Inpatient Minimum Dataset for admissions for AMI in the 12 months after the index admission.


METHODS
Victorian acute care hospitals from July 1995 to December 1997.


METHODS
Victorian residents aged 15-85 years admitted to hospital with AMI.


METHODS
Rates of coronary angiography or coronary artery revascularisation procedures after AMI.


RESULTS
Compared with public patients in public hospitals, patients with AMI managed in private hospitals were more likely to undergo coronary angiography (rate ratio [RR], 2.17; P< 0.001; 95% CI, 2.06-2.29), coronary angioplasty or stenting (RR, 3.05; P<0.001; 95% CI, 2.82-3.31), and coronary artery bypass grafting (RR, 1.95; P<0.001; 95% CI, 1.79-2.14). Once coronary angiography had been performed, patients in private hospitals were more likely to undergo angioplasty or stenting (RR, 1.94; P<0.001; 95% CI, 1.79-2.11), but were only marginally more likely to undergo coronary artery bypass grafting (RR, 1.17; P<0.001; 95% CI, 1.07-1.28).


CONCLUSIONS
In Victoria, management of patients with acute myocardial infarction is influenced by the public or private status of the patient, and by whether management occurs in private or public hospitals. Patients are more likely to undergo coronary angiography and coronary artery revascularisation procedures in private hospitals.
Robertson
I K
IK
Health Economics Unit, Monash University, Melbourne, VIC. iain.robertson@buseco.monash.edu.au
Richardson
J R
JR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D005260:Female; D016304:Hospitals, Private / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D009204:Myocardial Revascularization / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data; D014739:Victoria