Journal article
Trends in Permanent Pacemaker Implantation in the United States From 1993 to 2009 Increasing Complexity of Patients and Procedures
Journal of the American College of Cardiology, v 60(16), pp 1540-1545
16 Oct 2012
PMID: 22999727
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objectives This study sought to define contemporary trends in permanent pacemaker use by analyzing a large national database.
Background The Medicare National Coverage Determination for permanent pacemaker, which emphasized single-chamber pacing, has not changed significantly since 1985. We sought to define contemporary trends in permanent pacemaker use by analyzing a large national database.
Methods We queried the Nationwide Inpatient Sample to identify permanent pacemaker implants between 1993 and 2009 using the International Classification of Diseases-Ninth Revision-Clinical Modification procedure codes for dual-chamber (DDD), single-ventricular (VVI), single-atrial (AAI), or biventricular (BiV) devices. Annual permanent pacemaker implantation rates and patient demographics were analyzed.
Results Between 1993 and 2009, 2.9 million patients received permanent pacemakers in the United States. Overall use increased by 55.6%. By 2009, DDD use increased from 62% to 82% (p < 0.001), whereas single-chamber ventricular pacemaker use fell from 36% to 14% (p = 0.01). Use of DDD devices was higher in urban, nonteaching hospitals (79%) compared with urban teaching hospitals (76%) and rural hospitals (72%). Patients with private insurance (83%) more commonly received DDD devices than Medicaid (79%) or Medicare (75%) recipients (p < 0.001). Patient age and Charlson comorbidity index increased over time. Hospital charges ($2011) increased 45.3%, driven by the increased cost of DDD devices.
Conclusions There is a steady growth in the use of permanent pacemakers in the United States. Although DDD device use is increasing, whereas single-chamber ventricular pacemaker use is decreasing. Patients are becoming older and have more medical comorbidities. These trends have important health care policy implications. (J Am Coll Cardiol 2012;60:1540-5) (c) 2012 by the American College of Cardiology Foundation
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Details
- Title
- Trends in Permanent Pacemaker Implantation in the United States From 1993 to 2009 Increasing Complexity of Patients and Procedures
- Creators
- Arnold J. Greenspon - Thomas Jefferson University HospitalJasmine D. Patel - Drexel UniversityEdmund Lau - Drexel UniversityJorge A. Ochoa - ExponentDaniel R. Frisch - Thomas Jefferson University HospitalReginald T. Ho - Thomas Jefferson University HospitalBehzad B. Pavri - Thomas Jefferson University HospitalSteven M. Kurtz - Exponent (United States)
- Publication Details
- Journal of the American College of Cardiology, v 60(16), pp 1540-1545
- Publisher
- Elsevier
- Number of pages
- 6
- Grant note
- Biotronik Medtronic Boston Scientific BIOMET St. Jude Medical Exponent, Inc. Stryker
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- School of Biomedical Engineering, Science, and Health Systems
- Web of Science ID
- WOS:000310198200012
- Scopus ID
- 2-s2.0-84867401976
- Other Identifier
- 991019167521904721
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- Collaboration types
- Industry collaboration
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems