Admission route and use of invasive procedures during hospitalization for acute myocardial infarction: analysis of 2007-2011 National Health Insurance database

Abstract

OBJECTIVESThe goal of this study was to investigate trends in admission to the emergency department and the use of invasive or surgical procedures during hospitalization for acute myocardial infarction (AMI) in Korea.METHODSThe National Health Insurance (NHI) claims database between 2007 and 2011 was used. We identified all admission claims that included codes from the tenth revision of the International Classification of Diseases beginning with I21 as the primary or secondary diagnosis. Information about the admission route, admission date, discharge date, and whether coronary artery angiography, angioplasty, or bypass surgery was performed was also obtained from the NHI database.RESULTSOf the 513,886 relevant admission claims over the five years encompassed by this study, 295,001 discrete episodes of admission for AMI were identified by analyzing the date and length of each admission and the interval between admissions. The number of AMI admissions gradually decreased from 66,883 in 2007 to 47,656 in 2011. The number and proportion of admissions through the emergency department also decreased from 38,118 (57.0%) in 2007 to 24,001 (50.4%) in 2011. However, during the same period, admissions in which invasive or surgical procedures were performed increased from 15,342 (22.9%) to 17,505 (36.7%).CONCLUSIONSThe reported numbers of emergency department visits and admissions for AMI decreased from 2007 to 2011. However, only a small portion of the patients underwent invasive or surgical procedures during hospitalization, although the number of admissions involving invasive or surgical procedures has increased. These findings suggest that simply counting the number of admission claims cannot provide valid information on trends in AMI occurrence.

Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

“…The generalisability of claims data, the validity of assuming diagnoses based on primary diagnosis alone or all diagnostic fields, and the validity of trends in claims data have been challenged. 52 , 53 , 54 , 55 , 56 Also, there may be considerable inter-country variation in how diseases are treated between inpatient and outpatient settings. Our models attempt to adjust for such potential biases by using a covariate on claims and hospital admission data to correct for systematic error, although in a relatively crude manner, this assumes no geographical variation in the error.…”

Antidepressant Use and the Risk of Major Adverse Cardiovascular Events in Patients Without Known Cardiovascular Disease: A Retrospective Cohort Study

“…For CVD outcome, MACEs were used as the primary endpoints: myocardial infarction (MI) (I21), stroke (I60-I64), and CVD (I00-I99) related death. The use of invasive or surgical procedures during hospitalization for MI and stroke was additionally considered for validation ( Yeom et al, 2015 ). Stroke was classified as hemorrhagic (I60-I62), ischemic (I63), or other (I64).…”

Comparative Effectiveness of Sodium-Glucose Cotransporter 2 Inhibitors vs the Other Hypoglycemic Drugs on Major Adverse Cardiovascular Events and Hospitalization for Heart Failure in Patients with Type 2 Diabetes Mellitus and Atrial Fibrillation

“…Relevant procedural codes were additionally considered to enhance the validity of myocardial infarction or ischemic stroke episodes. [21] Hospitalization for heart failure was de ned as an admission (≥1 day) with a main or subsidiary diagnosis of heart failure (ICD-10 code I50). Detailed de nitions of the study outcomes are described in Supplementary Table 2.…”