Please use this identifier to cite or link to this item: http://buratest.brunel.ac.uk/handle/2438/10640
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dc.contributor.authorBrooks, JM-
dc.contributor.authorCook, EA-
dc.contributor.authorChapman, CG-
dc.contributor.authorKulchaitanaroaj, P-
dc.contributor.authorChrischelles, EA-
dc.contributor.authorWelch, S-
dc.contributor.authorRobinson, J-
dc.coverage.spatialThe United States of America-
dc.coverage.spatialThe United States of America-
dc.coverage.spatialThe United States of America-
dc.coverage.spatialThe United States of America-
dc.coverage.spatialThe United States of America-
dc.coverage.spatialThe United States of America-
dc.coverage.spatialThe United States of America-
dc.date.accessioned2015-04-23T14:41:07Z-
dc.date.available2014-03-
dc.date.available2015-04-23T14:41:07Z-
dc.date.issued2014-
dc.identifier.citationMedical Care, 2014, 52 pp. S37 - s44 (8)en_US
dc.identifier.urihttp://bura.brunel.ac.uk/handle/2438/10640-
dc.descriptionReprinted with permission of publisher.en_US
dc.description.abstractBACKGROUND: Despite strong evidence to designate statin use for secondary prevention of cardiovascular disease (CVD) as "effective care," observational studies show that many patients with CVD do not receive statins. This suggests that statin prescribing decisions for complex CVD patients are preference sensitive. OBJECTIVES: The aim of this study was to evaluate local area variation in statin prescribing for subsets of complex patients after acute myocardial infarction (AMI) to assess whether current statin prescribing patterns fit profiles of either "effective care" or "preference-sensitive care." RESEARCH DESIGN AND SUBJECTS: This was a retrospective cohort study of 124,618 Medicare patients with fee-for-service parts A, B, and D benefits who were hospitalized with AMI in 2008 or 2009 with no evidence of AMI in the past 12 months. MEASURES:Patient complexity was defined by the presence of diabetes, heart failure, and chronic kidney disease in the year before AMI admission. Local area practice styles for "no statin," "lower-intensity statins," and "high-intensity statins" were measured using the driving area for clinical care method. Statin prescribing rates for complex patient subsets were contrasted across patients grouped by local areas practice styles. RESULTS: Lower statin treatment rates were observed for patients with complex conditions, especially among those with heart failure. However, substantial local area variation in statin prescribing is observed across all complex patient groups. CONCLUSIONS: Despite guidelines promoting the use of statins for secondary prevention for CVD patients, substantial local area variation suggests that patient and provider beliefs and preferences weigh heavily in statin prescribing decisions.en_US
dc.description.sponsorshipThis project was supported by an Agency for Healthcare Research and Quality grant (1R21HS019574-01) under the American Recovery and Reinvestment Act of 2009.en_US
dc.format.extentS37 - s44 (8)-
dc.format.extentS37 - s44 (8)-
dc.format.extentS37 - s44 (8)-
dc.format.extentS37 - s44 (8)-
dc.format.extentS37 - s44 (8)-
dc.format.extentS37 - s44 (8)-
dc.format.extentS37 - s44 (8)-
dc.languageEnglish-
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.subjectStatinsen_US
dc.subjectGeographic variationen_US
dc.subjectAMIen_US
dc.subjectEffective careen_US
dc.titleGeographic variation in statin use for complex acute myocardial infarction patients: evidence of effective care?en_US
dc.typeArticleen_US
dc.identifier.doihttp://dx.doi.org/10.1097/MLR.0b013e3182a7fc3d-
dc.relation.isPartOfMedical Care-
dc.relation.isPartOfMedical Care-
dc.relation.isPartOfMedical Care-
dc.relation.isPartOfMedical Care-
dc.relation.isPartOfMedical Care-
dc.relation.isPartOfMedical Care-
dc.relation.isPartOfMedical Care-
pubs.publication-statusPublished-
pubs.publication-statusPublished-
pubs.publication-statusPublished-
pubs.publication-statusPublished-
pubs.publication-statusPublished-
pubs.publication-statusPublished-
pubs.publication-statusPublished-
pubs.volume52-
pubs.volume52-
pubs.volume52-
pubs.volume52-
pubs.volume52-
pubs.volume52-
pubs.volume52-
pubs.organisational-data/Brunel-
pubs.organisational-data/Brunel/Brunel Staff by College/Department/Division-
pubs.organisational-data/Brunel/Brunel Staff by College/Department/Division/College of Health and Life Sciences-
pubs.organisational-data/Brunel/Brunel Staff by College/Department/Division/College of Health and Life Sciences/Dept of Life Sciences-
pubs.organisational-data/Brunel/Brunel Staff by College/Department/Division/College of Health and Life Sciences/Dept of Life Sciences/Biological Sciences-
pubs.organisational-data/Brunel/Specialist Centres-
pubs.organisational-data/Brunel/Specialist Centres/HERG-
Appears in Collections:Health Economics Research Group (HERG)

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