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In this retrospective study, researchers used registry data to compare rates of invasive cardiac procedures in two similarly populated areas with different healthcare reimbursement systems: New York State (NY) and Ontario, Canada. Per capita, NY has about twice as many interventional cardiologists, cardiac surgeons, and hospitals with cardiac invasive facilities as Ontario.
During 2004–2006, the age- and sex-adjusted rate of coronary revascularization was 1.7 times higher in NY than in Ontario, a difference due almost entirely to a higher rate of percutaneous coronary intervention (PCI). The difference was greater in patients without myocardial infarction (MI) than in those with MI. In patients with acute MI, the PCI rate in Ontario increase…