Trends in clinical and economic outcomes of coronary angioplasty from 1992to 1995: A population-based analysis

Background The impact of recent developments in coronary angioplasty on the brood spectrum of patients treated in routine practice is largely undefine d. Analysis of population-based data can provide insight into trends in cli nical outcomes and associated costs of coronary angioplasty procedures. Methods and Results With the use of a comprehensive hospital discharge data base covering more than 11 million Canadians, we analyzed 12,748 first-time angioplasty procedures performed from 1992 to 1995 inclusive. Patient demo graphics and major adverse events were recorded. With the use of forward li nkage, readmissions within 12 months were classified according to procedure performed and/or most responsible diagnosis, The proportion of patients re admitted, the number of readmissions per index procedure, and diagnosis-spe cific readmission costs were compared by calendar year. Over the 4-year stu dy period, there was a 21% increase in the annual volume of index procedure s. There were no statistically significant differences between 1992 and 199 5 in sex distribution, mean age, comorbid conditions, length of stay, or ne ed for coronary bypass surgery related to the index procedure. The all-caus e readmission rate declined from 51.6% to 47.2% between 1992 and 1995 (P <. 001), primarily because of a decline in the admission rate for repeat revas cularization from 24.8% to 19.6% (P <.001). The 12-month readmission cost d eclined by $435 (1994 Canadian dollars) per patient. Conclusions The clinical outcomes of coronary angioplasty in a broad cohort of patients have improved in recent years. Although readmissions within ye ar of an angioplasty procedure remain common, the number related to repeat revascularization has declined, with an associated decline in downstream co sts.