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Circulation. 2001 Dec 11;104(24):2898-904.

Comparison of use of medications after acute myocardial infarction in the Veterans Health Administration and Medicare.

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1
Houston Center for Quality of Care and Utilization Studies, a Health Services Research and Development Center of Excellence, Houston VAMedical Center, Houston, TX 77030, USA. laurap@bcm.tmc.edu.

Abstract

BACKGROUND:

There is concern that care provided in the Veterans Health Administration (VA) may be of poorer quality than non-VA health care. We compared use of medications after acute myocardial infarction in the VA with that in non-VA healthcare settings under fee-for-service (FFS) Medicare financing.

METHODS AND RESULTS:

We used clinical data from 2486 VA and 29 249 FFS men >65 years old discharged with a confirmed diagnosis of acute myocardial infarction from 81 VA hospitals and 1530 non-VA hospitals. We reported odds ratios (ORs) for use of thrombolytics, beta-blockers, ACE inhibitors, or aspirin among ideal candidates adjusted for age, sample design (hospital academic affiliation, availability of cardiac procedures, and volume), and within-hospital clustering. Ideal VA candidates were more likely to undergo thrombolytic therapy at arrival (OR [VA relative to Medicare] 1.40 [1.05, 1.74]) or to receive ACE inhibitors (OR 1.67 [1.12, 2.45]) or aspirin (OR 2.32 [1.81, 3.01]) at discharge and equally likely to receive beta-blockers (OR 1.09 [1.03, 1.40]) at discharge.

CONCLUSIONS:

Ideal candidates in VA were at least as likely as those in FFS to receive medical therapies of known benefit for acute myocardial infarction.

PMID:
11739303
[Indexed for MEDLINE]
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