Using quality indicators to compare outcomes of permanent cardiac pacemaker implantation among publicly and privately funded patients

Pamela Bradshaw, P. Stobie, Kristjana Einarsdóttir, Tom Briffa, Michael Hobbs

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3 Citations (Scopus)

Abstract

© 2015 Royal Australasian College of Physicians. Background: Funding source/insurance status has been associated with disparity in the management and outcomes of cardiovascular disease, with poorer outcomes among disadvantaged groups. Aim: Using proposed quality indicators for permanent pacemaker (PPM) implantation and administrative data, this study aimed to determine whether quality indicator-based outcomes of PPM implantation were comparable for publicly and privately funded patients within Australia's two-tier health system. Methods: A population-based cohort study of adults implanted with a PPM between 1995 and 2009 in Western Australia. The association of funding outcomes derived from linked administrative data was tested in multivariate logistic regression models. Results: There were 9748 PPMs implanted, 48% being among privately funded patients. The mean age was 75 years for both public and private patients. Private patients had better health status (fewer with cardiac conditions and lower non-cardiac comorbidity scores), were less likely to be an emergency admission (33% vs 60%, P <0.001) and more likely to have dual- or triple-chamber pacing. Mean length of stay was significantly greater for private patients (4.3 (standard deviation 6.3) vs 5.1 (6.8) days
Original languageEnglish
Pages (from-to)813-820
JournalInternal Medicine Journal
Volume45
Issue number8
DOIs
Publication statusPublished - 2015

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Logistic Models
Western Australia
Insurance Coverage
Vulnerable Populations
Health Status
Comorbidity
Length of Stay
Emergencies
Cohort Studies
Cardiovascular Diseases
Physicians
Health
Population

Cite this

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title = "Using quality indicators to compare outcomes of permanent cardiac pacemaker implantation among publicly and privately funded patients",
abstract = "{\circledC} 2015 Royal Australasian College of Physicians. Background: Funding source/insurance status has been associated with disparity in the management and outcomes of cardiovascular disease, with poorer outcomes among disadvantaged groups. Aim: Using proposed quality indicators for permanent pacemaker (PPM) implantation and administrative data, this study aimed to determine whether quality indicator-based outcomes of PPM implantation were comparable for publicly and privately funded patients within Australia's two-tier health system. Methods: A population-based cohort study of adults implanted with a PPM between 1995 and 2009 in Western Australia. The association of funding outcomes derived from linked administrative data was tested in multivariate logistic regression models. Results: There were 9748 PPMs implanted, 48{\%} being among privately funded patients. The mean age was 75 years for both public and private patients. Private patients had better health status (fewer with cardiac conditions and lower non-cardiac comorbidity scores), were less likely to be an emergency admission (33{\%} vs 60{\%}, P <0.001) and more likely to have dual- or triple-chamber pacing. Mean length of stay was significantly greater for private patients (4.3 (standard deviation 6.3) vs 5.1 (6.8) days",
author = "Pamela Bradshaw and P. Stobie and Kristjana Einarsd{\'o}ttir and Tom Briffa and Michael Hobbs",
year = "2015",
doi = "10.1111/imj.12762",
language = "English",
volume = "45",
pages = "813--820",
journal = "Internal Medicine Journal (Print)",
issn = "1444-0903",
publisher = "John Wiley & Sons",
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TY - JOUR

T1 - Using quality indicators to compare outcomes of permanent cardiac pacemaker implantation among publicly and privately funded patients

AU - Bradshaw, Pamela

AU - Stobie, P.

AU - Einarsdóttir, Kristjana

AU - Briffa, Tom

AU - Hobbs, Michael

PY - 2015

Y1 - 2015

N2 - © 2015 Royal Australasian College of Physicians. Background: Funding source/insurance status has been associated with disparity in the management and outcomes of cardiovascular disease, with poorer outcomes among disadvantaged groups. Aim: Using proposed quality indicators for permanent pacemaker (PPM) implantation and administrative data, this study aimed to determine whether quality indicator-based outcomes of PPM implantation were comparable for publicly and privately funded patients within Australia's two-tier health system. Methods: A population-based cohort study of adults implanted with a PPM between 1995 and 2009 in Western Australia. The association of funding outcomes derived from linked administrative data was tested in multivariate logistic regression models. Results: There were 9748 PPMs implanted, 48% being among privately funded patients. The mean age was 75 years for both public and private patients. Private patients had better health status (fewer with cardiac conditions and lower non-cardiac comorbidity scores), were less likely to be an emergency admission (33% vs 60%, P <0.001) and more likely to have dual- or triple-chamber pacing. Mean length of stay was significantly greater for private patients (4.3 (standard deviation 6.3) vs 5.1 (6.8) days

AB - © 2015 Royal Australasian College of Physicians. Background: Funding source/insurance status has been associated with disparity in the management and outcomes of cardiovascular disease, with poorer outcomes among disadvantaged groups. Aim: Using proposed quality indicators for permanent pacemaker (PPM) implantation and administrative data, this study aimed to determine whether quality indicator-based outcomes of PPM implantation were comparable for publicly and privately funded patients within Australia's two-tier health system. Methods: A population-based cohort study of adults implanted with a PPM between 1995 and 2009 in Western Australia. The association of funding outcomes derived from linked administrative data was tested in multivariate logistic regression models. Results: There were 9748 PPMs implanted, 48% being among privately funded patients. The mean age was 75 years for both public and private patients. Private patients had better health status (fewer with cardiac conditions and lower non-cardiac comorbidity scores), were less likely to be an emergency admission (33% vs 60%, P <0.001) and more likely to have dual- or triple-chamber pacing. Mean length of stay was significantly greater for private patients (4.3 (standard deviation 6.3) vs 5.1 (6.8) days

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JO - Internal Medicine Journal (Print)

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SN - 1444-0903

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