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Specialty Cardiac Hospitals and Coronary Revascularization Rates—Reply
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In Reply: We appreciate clarifications by Dr Stensland and colleagues regarding the MedPAC report from August 2006. We agree that findings from that report and our study are largely consistent despite some methodological differences. And indeed, our comment that results "differ somewhat" between the 2 studies was primarily based on a mixed statistical association between the opening of cardiac hospitals and percutaneous coronary intervention rates found in that report.
Consistent findings between the 2 studies are important to highlight. We note that the Deficit Reduction Act Final Report to Congress stated that "the evidence thus far is inconclusive as to whether ownership of specialty hospitals leads to significant increase in utilization" even though testimony from the MedPAC report was available at the time.1 Although it remains unclear exactly why coronary revascularization rates increase after the opening of cardiac hospitals, we agree with Stensland et al that existing evidence supports this . . . [Full Text of this Article]
Brahmajee K. Nallamothu, MD, MPH
bnallamo@umich.edu
John D. Birkmeyer, MD
University of Michigan Medical School
Ann Arbor
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