Abstract

BackgroundKorea has seen a rapid increase in the use of percutaneous coronary intervention (PCI) with the ratio of PCI to coronary artery bypass graft (CABG) the highest in the world. This study was performed to examine the factors associated with the rates of CABG and PCI.MethodsThe data were acquired from the National Health Insurance database in Korea in 2013. We calculated the age-sex standardized rates of CABG and PCI. We examined the factors associated with the CABG and PCI rates by performing a regression analysis.ResultsThe rate of CABG showed a negative association with the deprivation index score, and other factors, such as the number of providers or hospital beds, did not show any significant association with the CABG rate. The rate of PCI had a strong negative association with the number of cardiothoracic surgeons and a strong positive association with the number of hospital beds.ConclusionsThe positive association between the PCI rate and the number of hospital beds suggests that the use of PCI may be driven by the supply of beds, and the inverse association between the PCI rate and the number of cardiothoracic surgeons indicates the overuse of PCI due to lack of the providers of CABG. Policy measures should be taken to optimize the use of revascularization procedures, the choice of which should primarily be based on the patient’s need.

Highlights

  • Korea has seen a rapid increase in the use of percutaneous coronary intervention (PCI) with the ratio of PCI to coronary artery bypass graft (CABG) the highest in the world

  • There were a total of 3086 CABGs and 68,452 PCIs among persons aged 20 and over in Korea in 2013 (Additional file 1 Table S1)

  • The results of the regression analyses showed a different pattern between the rates of CABG and PCI (Table 2)

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Summary

Introduction

Korea has seen a rapid increase in the use of percutaneous coronary intervention (PCI) with the ratio of PCI to coronary artery bypass graft (CABG) the highest in the world. The choice of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) for the treatment of coronary artery disease has long been a debatable issue. The indications for PCI continued to expand with its technical advancement. This advancement of PCI, combined with its merit in terms of lower invasiveness and cost, resulted in the rapid augmentation of the volume of PCI and relative shrinkage of CABG [1]. The use of CABG and PCI requires consideration of various elements such as the medical technology, costs, invasiveness, and patients’ preferences [7]. If the choice between the two procedures is determined by causes which are external to the patients’ health and are opposed to health care costs, it may not be in the best interest of the patients

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