title: Mortality and treatment patterns among patients hospitalized with acute cardiovascular conditions during dates of national cardiology meetings.
abstract: OBJECTIVE
  Thousands of physicians attend scientific meetings annually. Although hospital physician staffing and composition may be affected by meetings, patient outcomes and treatment patterns during meeting dates are unknown.
  
  
  OBJECTIVE
  To analyze mortality and treatment differences among patients admitted with acute cardiovascular conditions during dates of national cardiology meetings compared with nonmeeting dates.
  
  
  METHODS
  Retrospective analysis of 30-day mortality among Medicare beneficiaries hospitalized with acute myocardial infarction (AMI), heart failure, or cardiac arrest from 2002 through 2011 during dates of 2 national cardiology meetings compared with identical nonmeeting days in the 3 weeks before and after conferences (AMI, 8570 hospitalizations during 82 meeting days and 57,471 during 492 nonmeeting days; heart failure, 19,282 during meeting days and 11,4591 during nonmeeting days; cardiac arrest, 1564 during meeting days and 9580 during nonmeeting days). Multivariable analyses were conducted separately for major teaching hospitals and nonteaching hospitals and for low- and high-risk patients. Differences in treatment utilization were assessed.
  
  
  METHODS
  Hospitalization during cardiology meeting dates.
  
  
  METHODS
  Thirty-day mortality, procedure rates, charges, length of stay.
  
  
  RESULTS
  Patient characteristics were similar between meeting and nonmeeting dates. In teaching hospitals, adjusted 30-day mortality was lower among high-risk patients with heart failure or cardiac arrest admitted during meeting vs nonmeeting dates (heart failure, 17.5% [95% CI, 13.7%-21.2%] vs 24.8% [95% CI, 22.9%-26.6%]; P < .001; cardiac arrest, 59.1% [95% CI, 51.4%-66.8%] vs 69.4% [95% CI, 66.2%-72.6%]; P = .01). Adjusted mortality for high-risk AMI in teaching hospitals was similar between meeting and nonmeeting dates (39.2% [95% CI, 31.8%-46.6%] vs 38.5% [95% CI, 35.0%-42.0%]; P = .86), although adjusted percutaneous coronary intervention (PCI) rates were lower during meetings (20.8% vs 28.2%; P = .02). No mortality or utilization differences existed for low-risk patients in teaching hospitals or high- or low-risk patients in nonteaching hospitals. In sensitivity analyses, cardiac mortality was not affected by hospitalization during oncology, gastroenterology, and orthopedics meetings, nor was gastrointestinal hemorrhage or hip fracture mortality affected by hospitalization during cardiology meetings.
  
  
  CONCLUSIONS
  High-risk patients with heart failure and cardiac arrest hospitalized in teaching hospitals had lower 30-day mortality when admitted during dates of national cardiology meetings. High-risk patients with AMI admitted to teaching hospitals during meetings were less likely to receive PCI, without any mortality effect.
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts2Massachusetts General Hospital, Boston3National Bureau of Economic Research, Cambridge, Massachusetts.
authors.forename: Anupam B
authors.initials: AB
authors.lastname: Jena
authors.affiliation: Medical Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Vinay
authors.initials: V
authors.lastname: Prasad
authors.affiliation: National Bureau of Economic Research, Cambridge, Massachusetts5Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles6RAND Corporation, Santa Monica, California.
authors.forename: Dana P
authors.initials: DP
authors.lastname: Goldman
authors.affiliation: Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles6RAND Corporation, Santa Monica, California.
authors.forename: John
authors.initials: J
authors.lastname: Romley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002309:Cardiology / Q000458:organization & administration*; D003226:Congresses as Topic; D005260:Female; D006331:Heart Diseases / Q000401:mortality* / Q000628:therapy; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology