Inpatient utilization of medical services associated with peripheral arterial disease-related inpatient procedures in the Department of Defense.
The objective of this study was to describe the inpatient procedural medical care utilization the first 10 years after initial inpatient confirmation of peripheral arterial disease (PAD). A retrospective review was carried out of the computer records of all the army beneficiaries of the Department of Defense healthcare system since 1971. Over 8000 subjects with an initial inpatient confirmation of PAD between January 1, 1980 and December 31, 1985 were reviewed for 10 years following the initial visit. The utilization of PAD-related invasive procedures gradually increased over the first 8 years, and rose sharply in the ninth and tenth years after initial diagnosis, while the utilization of examination procedures was highest in the first, fifth to seventh, ninth and tenth years. Procedures involving bypass and amputation had the highest utilization among invasive procedures, while procedures involving arteriography and ultrasonography accounted for 88% of all examination procedures. Bypass and repair of vessel procedures gradually rose throughout the 10 years after initial diagnosis, while amputations and skin grafts remained relatively constant. Procedures involving arteriography rose until year 5 and then tapered off, while utilization of ultrasonography rose in year 7 and tapered off. These results suggest that PAD-related studies should consider the progression of the disease past the fifth year after the initial inpatient visit for PAD when measuring a change in outcomes.
Zachry
W M
WM
The University of Arizona, Tucson 85721-0207, USA. zachry@pharmacy.arizona.edu
Shepherd
M D
MD
Wilson
J P
JP
D000328:Adult; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D003201:Computers; D003695:Delivery of Health Care / Q000379:methods* / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006772:Hospitals, Military; D006801:Humans; D007297:Inpatients; D008297:Male; D008499:Medical Records; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology