title: National priorities partnership focus on eliminating overuse: applications to cardiac revascularization.
abstract: As one of several initiatives to transform health care delivery across the United States, the National Priorities Partnership has identified "eliminating overuse while ensuring the delivery of appropriate care" as a top priority. Cardiac revascularization procedures, including coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), constitute one area of focus for reduction of overuse. Despite the multiyear development of clinical guidelines to define appropriate use of cardiac revascularization, substantial variability in the application of these procedures is observed. Concurrent data collection tools to support real-time clinical decision making regarding appropriateness are needed and can be used, along with financial incentives such as pay-for-performance programs and public reporting of performance information, to support more appropriate use of cardiac revascularization. Efforts to achieve more rational use of CABG and PCI should be made carefully and with the goal that patients receive the most appropriate and effective care.
authors.affiliation: Institute for Health Care Research and Improvement, Baylor Health Care System, 8080 North Central Expressway, Dallas, TX 75206, USA. dj.ballard@baylorhealth.edu
authors.forename: David J
authors.initials: DJ
authors.lastname: Ballard
authors.forename: Bradley M
authors.initials: BM
authors.lastname: Leonard
mesh_terms: D017046:Cost Savings; D003661:Decision Support Techniques; D019983:Guideline Adherence; D006292:Health Priorities; D006801:Humans; D009204:Myocardial Revascularization / Q000191:economics / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D058996:Quality Improvement; D018570:Risk Assessment; D014481:United States