The Appropriateness of the Use of Cardiovascular Procedures

British Versus U.S. Perspectives

by Steven J. Bernstein, Jacqueline Kosecoff, D. Gray, John R. Hampton, Robert H. Brook


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To determine whether patients are less likely to receive an inappropriate procedure in countries that devote fewer resources to health care than does the United States, the authors studied how appropriately coronary angiography and coronary artery bypass surgery were performed in the Trent region of the United Kingdom. The medical records of 320 patients who underwent coronary angiography and 319 who underwent coronary artery bypass surgery in 1987 and 1988 were randomly selected for review. Despite the United Kingdom's more limited use of coronary angiography and coronary artery bypass surgery, a substantial portion were still performed for less than appropriate reasons, both by U.S. and U.K. criteria. Merely reducing the rate of use of these procedures will not be sufficient to eliminate such inappropriate use.

Originally published in: International Journal of Technology Assessment in Health Care, v. 9, no. 1, 1993, pp. 3-10.

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