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Changes in the Practice of Coronary Revascularization between 2006 and 2010 in the Republic of Korea

 Yoon Jung Choi  ;  Jin-Bae Kim  ;  Su-Jin Cho  ;  Jaelim Cho  ;  Jungwoo Sohn  ;  Seong-Kyung Cho  ;  Kyoung Hwa Ha  ;  Changsoo Kim 
 YONSEI MEDICAL JOURNAL, Vol.56(4) : 895-903, 2015 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Coronary Artery Bypass/statistics & numerical data* ; Coronary Artery Bypass/trends ; Coronary Artery Disease/surgery* ; Drug-Eluting Stents ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Myocardial Revascularization/methods* ; Myocardial Revascularization/trends* ; Percutaneous Coronary Intervention/statistics & numerical data* ; Percutaneous Coronary Intervention/trends ; Republic of Korea/epidemiology
Myocardial revascularization ; insurance ; percutaneous coronary intervention ; reimbursement
PURPOSE: Evidence suggests that technological innovations and reimbursement schemes of the National Health Insurance Service may have impacted the management of coronary artery disease. Thus, we investigated changes in the practice patterns of coronary revascularization. MATERIALS AND METHODS: Revascularization and in-hospital mortality among Koreans ≥20 years old were identified from medical claims filed between 2006 and 2010. The age- and sex-standardized procedure rate per 100,000 person-years was calculated directly from the distribution of the 2008 Korean population. RESULTS: The coronary revascularization rate increased from 116.1 (95% confidence interval, 114.9-117.2) in 2006 to 131.0 (129.9-132.1) in 2010. Compared to the rate ratios in 2006, the rate ratios for percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery in 2010 were 1.16 (1.15-1.17) and 0.80 (0.76-0.84), respectively. Among patients who received PCI, the percentage with drug-eluting stents increased from 89.1% in 2006 to 93.0% in 2010. In-hospital mortality rates from PCI significantly increased during the study period (p=0.03), whereas those from CABG significantly decreased (p=0.01). The in-hospital mortality rates for PCI and CABG were higher in elderly and female patients and at the lowest-volume hospitals. CONCLUSION: The annual volume of coronary revascularization continuously increased between 2006 and 2010 in Korea, although this trend differed according to procedure type. A high percentage of drug-eluting stent procedures and a high rate of in-hospital mortality at low-volume hospitals were noted.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chang Soo(김창수) ORCID logo https://orcid.org/0000-0002-5940-5649
Sohn, Jung Woo(손정우)
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