TY - JOUR
T1 - Variation among cardiologists in the utilization of right heart catheterization at time of coronary angiography
AU - Malone, Michael L.
AU - Bajwa, Tanvir K.
AU - Battiola, Richard J.
AU - Fortsas, Michael
AU - Aman, Saleem
AU - Solomon, David J.
AU - Goodwin, James S.
PY - 1996/2
Y1 - 1996/2
N2 - To describe how often a right heart catheterization was performed at the time of coronary angiography, the patient characteristics that predicted the use of this procedure, and the variation among cardiologists in the use of this test, we reviewed all cases of coronary angiography (n = 1,282) during the first 2 mo of 1993 at two large community hospitals. Fifty-two percent of the cases received a right heart catheterization at the time of their coronary angiography. The following characteristics were associated with the receipt of a right heart catheterization in a logistic regression analysis: cardiomyopathy (odds ratio = 2.59, 95% Cl = 1.01, 6.62), congestive heart failure (odds ratio = 2.07, 95% Cl = 1.42, 3.01), valvular heart disease (odds ratio = 2.54, 95% Cl = 1.44, 4.49), no coronary angioplasty performed at the procedure (odds ratio = 2.71, 95% Cl = 2.12, 3.45), and increased age (odds ratio = 1.13 per decade, 95% Cl = 1.03, 1.25). Of 37 cardiologists who performed 10 coronary angiography procedures, the use of right heart catheterization varied from 10-90%. The cardiologists' practice variation persisted after adjustment for patient clinical characteristics. Because of the high utilization of right heart catheterization at the time of coronary angiography and the variation in use among cardiologists, even when controlling for patient characteristics, the issue of appropriate indications for this procedure needs to be addressed in a rigorous fashion.
AB - To describe how often a right heart catheterization was performed at the time of coronary angiography, the patient characteristics that predicted the use of this procedure, and the variation among cardiologists in the use of this test, we reviewed all cases of coronary angiography (n = 1,282) during the first 2 mo of 1993 at two large community hospitals. Fifty-two percent of the cases received a right heart catheterization at the time of their coronary angiography. The following characteristics were associated with the receipt of a right heart catheterization in a logistic regression analysis: cardiomyopathy (odds ratio = 2.59, 95% Cl = 1.01, 6.62), congestive heart failure (odds ratio = 2.07, 95% Cl = 1.42, 3.01), valvular heart disease (odds ratio = 2.54, 95% Cl = 1.44, 4.49), no coronary angioplasty performed at the procedure (odds ratio = 2.71, 95% Cl = 2.12, 3.45), and increased age (odds ratio = 1.13 per decade, 95% Cl = 1.03, 1.25). Of 37 cardiologists who performed 10 coronary angiography procedures, the use of right heart catheterization varied from 10-90%. The cardiologists' practice variation persisted after adjustment for patient clinical characteristics. Because of the high utilization of right heart catheterization at the time of coronary angiography and the variation in use among cardiologists, even when controlling for patient characteristics, the issue of appropriate indications for this procedure needs to be addressed in a rigorous fashion.
KW - Clinical practice variations
KW - Heart catheterization
KW - Utilization
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U2 - 10.1002/(SICI)1097-0304(199602)37:2<125::AID-CCD4>3.0.CO;2-F
DO - 10.1002/(SICI)1097-0304(199602)37:2<125::AID-CCD4>3.0.CO;2-F
M3 - Article
C2 - 8808065
AN - SCOPUS:0030043987
SN - 0098-6569
VL - 37
SP - 125
EP - 130
JO - Catheterization and Cardiovascular Diagnosis
JF - Catheterization and Cardiovascular Diagnosis
IS - 2
ER -