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The Appropriateness of the Use of Cardiovascular Procedures: British Versus U.S. Perspectives

Published online by Cambridge University Press:  10 March 2009

Steven J. Bernstein
Affiliation:
University of California, Los Angeles
Jacqueline Kosecoff
Affiliation:
Value Health Sciences, Inc., Santa Monica
David Gray
Affiliation:
Value Health Sciences, Inc., Santa Monica
John R. Hampton
Affiliation:
University Hospital, Nottingham
Robert H. Brook
Affiliation:
RAND Corporation

Abstract

To determine whether patients are less likely to receive an inappropriate procedure in countries that devote fewer resources to health care than does the United States, we studied how appropriately coronary angiography and coronary artery bypass surgery were performed in the Trent region of the United Kingdom. The medical records of 320 patients who underwent coronary angiography and 319 who underwent coronary artery bypass surgery in 1987 and 1988 were randomly selected for review. Despite the United Kingdom's more limited use of coronary angiography and coronary artery bypass surgery, a substantial proportion were still performed for less than appropriate reasons, by both U.S. and U.K. criteria. Merely reducing the rate of use of these procedures will not be sufficient to eliminate such inappropriate use.

Type
General Essays
Copyright
Copyright © Cambridge University Press 1993

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References

REFERENCES

1.Bainton, D., Baker, I. A., Sweetnam, P. M, et al. Prevalence of ischemic heart disease: The Caerphilly and Speedwell surveys. British Heart Journal, 1988, 59, 201–06.CrossRefGoogle ScholarPubMed
2.Berman, D. M., Brook, R. H., Lohr, K. N., et al. Conceptualization and measurement of physiologic health for adults: Angina pectoris. Santa Monica, CA: The RAND Corporation, R-2262/4-HHS, 1981.Google Scholar
3.Brook, R. H., Chassin, M. R., Fink, A., et al. A method for the detailed assessment of the appropriateness of medical technologies. International Journal of Technology Assessment in Health Care, 1986, 2, 5363.CrossRefGoogle ScholarPubMed
4.Brook, R. H., Kosecoff, J., Park, R. E., et al. Diagnosis and treatment of coronary disease: Comparison of doctors’ attitudes in the USA and the UK. Lancet, 1988, i, 750–53.CrossRefGoogle Scholar
5.Brook, R. H., & Lohr, K. N.Efficacy, effectiveness, variations, and quality: Boundary-crossing research. Medical Care, 1985, 23, 710–22.CrossRefGoogle ScholarPubMed
6.Califano, J. A. Jr., The health-care chaos. The New York Times, 03 20,1988, Sec. 6, p. 44.Google Scholar
7.Campeau, L.Grading of angina pectoris. Circulation, 1976, 54, 522–23.CrossRefGoogle ScholarPubMed
8.Chassin, M. R., Brook, R. H., Park, R. E., et al. Variations in the use of medical and surgical services by the Medicare population. New England Journal of Medicine, 1986, 314, 285–90.CrossRefGoogle ScholarPubMed
9.Chassin, M. R., Kosecoff, J., Park, R. E., et al. Does inappropriate use explain geographic variations in the use of health care services? A study of three procedures. Journal of the American Medical Association, 1987, 258, 2533–37.CrossRefGoogle ScholarPubMed
10.Ellwood, P. M.Outcomes management: A technology of patient experience. New England Journal of Medicine, 1988, 318, 1549–56.CrossRefGoogle ScholarPubMed
11.Fink, A., Kosecoff, J., Chassin, M., & Brook, R. H.Consensus methods: Characteristics and guidelines for use. American Journal of Public Health, 1984, 74, 979–83.Google Scholar
12. Gray, D. Personal communication.Google Scholar
13.Gray, D., Hampton, J. R., Bernstein, S. J., et al. An audit of coronary angiography and coronary artery bypass surgery in the Trent region based on ratings of appropriateness. Lancet, 1990, 335, 1317–20.CrossRefGoogle Scholar
14.Kramer, M. S., & Feinstein, A. R.Clinical biostatistics: The biostatistics of concordance. Clinical Pharmacology and Therapeutics, 1981, 29, 111–23.CrossRefGoogle ScholarPubMed
15.Leape, L. L., Park, R. E., Solomon, D. H., et al. Does inappropriate use explain small-area variations in the use of health care services? Journal of the American Medical Association, 1990, 263, 669–72.CrossRefGoogle ScholarPubMed
16.McPherson, K., Wennberg, J. E., Hovind, O. B., & Clifford, P.Small-area variations in the use of common surgical procedures: An international comparison of New England, England, and Norway. New England Journal of Medicine, 1982, 307, 1310–14.CrossRefGoogle ScholarPubMed
17.National Center for Health Statistics. National hospital discharge survey: Annual summary, United States, 1987. Vital and health statistics. Series 13. No. 99. Washington, DC: Government Printing Office, 1989 (DHHS Publication no. [PHS] 89–1760).Google Scholar
18.Park, R. E., Fink, A., Brook, R..H., et al. Physician ratings of appropriate indications for six medical and surgical procedures. American Journal of Public Health, 1986, 76, 766–72.Google Scholar
19.Regional Office for Europe, World Health Organization. Monitoring of the strategy for health for all by the year 2000. Thirty-eighth session, Copenhagen, 09 12–17, 1988 (Working paper).Google Scholar
20.Rose, G., Reid, D. D., Hamilton, P. J. S., et al. Myocardial ischaemia, factors and death from coronary heart disease. Lancet, 1977, i, 105–09.CrossRefGoogle Scholar
21.Uemura, K., & Pisa, Z.Trends in cardiovascular disease mortality in industrialized countries since 1950. World Health Statistics Quarterly, 1988, 41, 155–76.Google Scholar
22.Vayda, E., Mindell, W. R., & Rutlow, I. M.A decade of surgery in Canada, England and Wales, and the United States. Archives of Surgery, 1982, 117, 846–53.CrossRefGoogle ScholarPubMed
23.Winslow, C. M., Kosecoff, J., Chassin, M. R., et al. The appropriateness of performing coronary artery bypass surgery. JAMA, 1988, 260, 505–09.CrossRefGoogle ScholarPubMed