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Acute Myocardial Infarction, Use of Percutaneous Coronary Intervention, and Mortality: A Comparative Effectiveness Analysis Covering Seven European Countries

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  • Terje P. Hagen
  • Unto Häkkinen
  • Eva Belicza
  • Giovanni Fatore
  • Fanny Goude
  • on behalf of the EuroHOPE study group

Abstract

Percutaneous coronary interventions (PCI) on acute myocardial infarction (AMI) patients have increased substantially in the last 12–15 years because of its clinical effectiveness. The expansion of PCI treatment for AMI patients raises two questions: How did PCI utilization rates vary across European regions, and which healthcare system and regional characteristic variables correlated with the utilization rate? Were the differences in use of PCI associated with differences in outcome, operationalized as 30‐day mortality? We obtained our results from a dataset based on the administrative information systems of the populations of seven European countries. PCI rates were highest in the Netherlands, followed by Sweden and Hungary. The probability of receiving PCI was highest in regions with their own PCI facilities and in healthcare systems with activity‐based reimbursement systems. Thirty‐day mortality rates differed considerably between the countries with the highest rates in Hungary, Scotland, and Finland. Mortality was lowest in Sweden and Norway. The associations between PCI and mortality were remarkable in all age groups and across most countries. Despite extensive risk adjustment, we interpret the associations both as effects of selection and treatments. We observed a lower effect of PCI in the higher age groups in Hungary. Copyright © 2015 John Wiley & Sons, Ltd.

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  • Terje P. Hagen & Unto Häkkinen & Eva Belicza & Giovanni Fatore & Fanny Goude & on behalf of the EuroHOPE study group, 2015. "Acute Myocardial Infarction, Use of Percutaneous Coronary Intervention, and Mortality: A Comparative Effectiveness Analysis Covering Seven European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 88-101, December.
    • Handle: RePEc:wly:hlthec:v:24:y:2015:i:s2:p:88-101
    DOI: 10.1002/hec.3263
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    1. Unto Häkkinen & Tor Iversen & Mikko Peltola & Clas Rehnberg & Timo T. Seppälä & on behalf of the EuroHOPE study group, 2015. "Towards Explaining International Differences in Health Care Performance: Results of the EuroHOPE Project," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 1-4, December.
    2. Richard Heijink & Peter Engelfriet & Clas Rehnberg & Sverre A. C. Kittelsen & Unto Häkkinen & on behalf of the EuroHOPE study group, 2015. "A Window on Geographic Variation in Health Care: Insights from EuroHOPE," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 164-177, December.
    3. Sverre A. C. Kittelsen & Kjartan S. Anthun & Fanny Goude & Ingrid M. S. Huitfeldt & Unto Häkkinen & Marie Kruse & Emma Medin & Clas Rehnberg & Hanna Rättö & on behalf of the EuroHOPE study group, 2015. "Costs and Quality at the Hospital Level in the Nordic Countries," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 140-163, December.

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