A comparison of abciximab use in MCO and non-MCO populations.
OBJECTIVE
To compare abciximab use in managed care organization (MCO) patients and non-MCO patients undergoing coronary angioplasty, specifically (1) the factors influencing abciximab use, (2) the impact of abciximab on hospital length of stay (LOS), and (3) differences in results in MCO and non-MCO patients.


METHODS
A retrospective observational study based on data from 87 US hospitals on 13,384 angioplasty patients.


METHODS
Multivariate analysis was used to control for a wide range of factors (patient demographics, health conditions, admission information, and hospital characteristics) that may influence the likelihood of receiving abciximab and hospital length of stay (LOS). Estimation was conducted via a 2-stage sample selection model.


RESULTS
Comorbidities, hospital characteristics, and geographic regions influenced abciximab use in MCO and non-MCO populations. In the non-MCO population, women and minority group members were significantly less likely than white male patients to receive abciximab. Both MCO and non-MCO angioplasty patients who were given abciximab had significantly shorter LOSs (0.66 +/- 0.27 fewer days and 0.87 +/- 0.13 fewer days, respectively) than did patients who were not given this drug.


CONCLUSIONS
Access to care for MCO and non-MCO populations differed. Non-MCO women and minorities were less likely than non-MCO white men to receive abciximab, but this difference was not observed in the MCO population. After controlling for high-risk indications and selection bias, MCO and non-MCO patients who received abciximab had significantly shorter LOSs than did those who did not receive abciximab. This finding is consistent with the many clinical trials that have observed a reduction in ischemic complications associated with abciximab use.
Lage
M J
MJ
Department of Economics, Miami University, Oxford, OH, USA.
Barber
B L
BL
Bala
M
M
Ball
D E
DE
Bowman
L
L
D000077284:Abciximab; D000368:Aged; D000787:Angina Pectoris / Q000601:surgery; D017130:Angioplasty; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000925:Anticoagulants / Q000627:therapeutic use*; D017723:Drug Utilization Review; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D007902:Length of Stay; D008297:Male; D008329:Managed Care Programs / Q000458:organization & administration*; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery; D012044:Regression Analysis; D012189:Retrospective Studies
D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D007140:Immunoglobulin Fab Fragments; D000077284:Abciximab