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The Relation Between Patients’ Outcomes and the Volume of Cardioverter-Defibrillator Implantation Procedures Performed by Physicians Treating Medicare Beneficiaries

Sana M. Al-Khatib, MD, MHS, FACC^_*,_*, F. Lee Lucas, PhD, James G. Jollis, MD^_*, David J. Malenka, MD and David E. Wennberg, MD

^_* Duke Clinical Research Institute, Durham, North Carolina
Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, Maine

View larger version (16K): [in a new window]   Figure 1 Distribution of physicians according to the annual volume of implantable cardioverter-defibrillator implantation procedures in Medicare beneficiaries during each year of the study period.

View larger version (31K): [in a new window]   Figure 2 Adjusted odds ratios for 90-day complications among Medicare beneficiaries who underwent implantable cardioverter-defibrillator implantation from 1999 through 2001 by physician quartile. Odds ratios were adjusted for age, gender, race, urgency of admission, Charlson comorbidity score, acute myocardial infarction, and pacemaker implant volume. Open bars = 1 to 10; ruled bars = 11 to 18; dotted bars = 19 to 28; solid bars = 29+.