Christoph Ohlmeier1, Jonas Czwikla2,3, Dirk Enders2, Rafael Mikolajczyk4,5, Rüdiger Blindt6,7, Dirk Horenkamp-Sonntag8, Roland Linder8, Edeltraut Garbe2,3. 1. IGES Institut GmbH, Berlin, Deutschland. christoph.ohlmeier@iges.com. 2. Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS, Bremen, Deutschland. 3. Wissenschaftsschwerpunkt "Gesundheitswissenschaften", Universität Bremen, Bremen, Deutschland. 4. Helmholtz-Zentrum für Infektionsforschung - HZI, Braunschweig, Deutschland. 5. Medizinische Hochschule Hannover - MHH, Hannover, Deutschland. 6. Kardio Bremen, Bremen, Deutschland. 7. Rotes Kreuz Krankenhaus Bremen, Bremen, Deutschland. 8. Wissenschaftliches Institut der TK für Nutzen und Effizienz im Gesundheitswesen - WINEG, Hamburg, Deutschland.
Abstract
BACKGROUND AND OBJECTIVE: Percutaneous coronary interventions (PCIs) are increasingly being performed in the treatment of coronary artery disease. The aim of this study is to describe the frequency of PCIs by age, sex, type, and setting of the intervention in Germany. METHODS: Based on routine data of more than eight million insurants from three statutory health insurance funds, quarterly sex- and age-specific intervention rates were calculated between 2004 and 2012. Moreover, inpatient PCIs were subdivided into PCIs with conventional bare metal stents (BMS) and PCIs with drug-eluting stents (DES). Rates were age- and sex-standardized according to the age and sex distribution of the particular years in Germany. RESULTS: Standardized rates increased from 277.3 to 382.2 per 100,000 person-years between 2004 and 2012. The intervention rate was three times higher in men than in women. The relative increase in the overall rate and in the rate of PCI with DES during the study period were 38 and 548 % respectively, whereas the rate of PCI with BMS declined by 48 %. Of all PCIs, 7-11 % were outpatient PCIs during the study period. CONCLUSIONS: PCIs are increasingly being performed in Germany, particularly PCI with DES. The frequency of PCI with BMS implantation is decreasing. Sex-specific differences in the frequency of PCI go beyond differences that would have been expected because of a differing morbidity profile. Our analyses indicate that comparatively few outpatient PCIs are performed.
BACKGROUND AND OBJECTIVE: Percutaneous coronary interventions (PCIs) are increasingly being performed in the treatment of coronary artery disease. The aim of this study is to describe the frequency of PCIs by age, sex, type, and setting of the intervention in Germany. METHODS: Based on routine data of more than eight million insurants from three statutory health insurance funds, quarterly sex- and age-specific intervention rates were calculated between 2004 and 2012. Moreover, inpatient PCIs were subdivided into PCIs with conventional bare metal stents (BMS) and PCIs with drug-eluting stents (DES). Rates were age- and sex-standardized according to the age and sex distribution of the particular years in Germany. RESULTS: Standardized rates increased from 277.3 to 382.2 per 100,000 person-years between 2004 and 2012. The intervention rate was three times higher in men than in women. The relative increase in the overall rate and in the rate of PCI with DES during the study period were 38 and 548 % respectively, whereas the rate of PCI with BMS declined by 48 %. Of all PCIs, 7-11 % were outpatient PCIs during the study period. CONCLUSIONS: PCIs are increasingly being performed in Germany, particularly PCI with DES. The frequency of PCI with BMS implantation is decreasing. Sex-specific differences in the frequency of PCI go beyond differences that would have been expected because of a differing morbidity profile. Our analyses indicate that comparatively few outpatient PCIs are performed.
Entities:
Keywords:
Coronary artery disease; Germany; Health insurance data; Health services research; Percutaneous coronary intervention
Authors: William J Hulme; Matthew Sperrin; Glen Philip Martin; Nick Curzen; Peter Ludman; Evangelos Kontopantelis; Mamas A Mamas Journal: BMJ Open Date: 2019-02-19 Impact factor: 2.692