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Influence of insurance type on the use of procedures, medications and hospital outcome in patients with unstable angina: results from the GUARANTEE registry

Nathan R. Every, MD, MPH^a, Christopher P. Cannon, MD, FACC^*, Christopher Granger, MD, FACC, David J. Moliterno, MD, FACC, Frank V. Aguirre, MD, FACC, J. David Talley, MD, FACC^||, Joan Booth, RN, Shelly Sapp, MS, James J. Ferguson, MD, FACC^¶ for the GUARANTEE investigators

^a Northwest Health Services Research and Development Program, Puget Sound Veteran’s Administration Healthcare System, Seattle, Washington, USA
^* Harvard Medical School, and Brigham and Women’s Hospital, Boston, Massachusetts, USA
Duke University Medical Center, Durham, North Carolina, USA
Cleveland Clinic Foundation, Cleveland, Ohio, USA
St. Louis University Hospital, St. Louis, Missouri, USA
^|| University of Arkansas, Little Rock, Arkansas, USA
^¶ Texas Heart Institute, Houston, Texas, USA

View larger version (19K): [in a new window]   Figure 1 Discharge medications in 2,948 unstable angina patients in the GUARANTEE Registry. The proportion of managed care versus fee-for-service patients discharged on aspirin, beta-blockers, nitrates and calcium channel blockers. Managed care patients were more likely to be discharged on guideline recommended medications.

View larger version (27K): [in a new window]   Figure 2 Odds ratio with 95% confidence intervals of factors associated with undergoing cardiac catheterization during the hospitalization in 2,948 unstable angina patients in the GUARANTEE Registry. Factors associated with a higher likelihood of undergoing angiography appear to the right of the line of identity. After adjustment for the listed factors, fee-for-service patients were 25% more likely to undergo cardiac catheterization.