{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:33:30Z","timestamp":1753889610809,"version":"3.41.2"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Assessments of healthcare value have largely focused on measuring outcomes of care at a given level of cost with less attention paid to appropriateness. However, understanding how appropriateness relates to outcomes and costs is essential to determining healthcare value.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods AND RESULTS:<\/jats:title>\n            <jats:p>In a retrospective cohort study design, administrative data from fee-for-service Medicare patients undergoing percutaneous coronary intervention (PCI) in Michigan hospitals between June 30, 2010, and December 31, 2014, were linked with clinical data from a statewide PCI registry to calculate hospital-level measures of (1) appropriate use criteria scores, (2) 90-day risk-standardized readmission and mortality rates, and (3) 90-day risk-standardized episode costs. We then used Spearman correlation coefficients to assess the relationship between these measures. A total of 29 839 PCIs were performed at 33 PCI hospitals during the study period. A total of 13.3% were for ST-segment\u2013elevation myocardial infarction, 25.0% for non\u2013ST-segment\u2013elevation myocardial infarction, 47.1% for unstable angina, 9.8% for stable angina, and 4.7% for other. The overall hospital-level mean appropriate use criteria score was 8.4\u00b10.2. Ninety-day risk-standardized readmission occurred in 23.7%\u00b13.7% of cases, 90-day risk-standardized mortality in 4.3%\u00b10.6%, and mean risk-standardized episode costs were $26 159\u00b1$1074. Hospital-level appropriate use criteria scores did not correlate with 90-day readmission, mortality, or episode costs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Among Medicare patients undergoing PCI in Michigan, we found hospital-level appropriate use criteria scores did not correlate with 90-day readmission, mortality, or episode costs. This finding suggests that a comprehensive understanding of healthcare value requires multidimensional consideration of appropriateness, outcomes, and costs.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.117.004328","type":"journal-article","created":{"date-parts":[[2018,5,31]],"date-time":"2018-05-31T09:05:18Z","timestamp":1527757518000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Exploring the Healthcare Value of Percutaneous Coronary Intervention"],"prefix":"10.1161","volume":"11","author":[{"given":"Daniel M.","family":"Alyesh","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine (D.M.A., D.S., H.S.G., B.K.N.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milan","family":"Seth","sequence":"additional","affiliation":[{"name":"University of Michigan Medical School, Ann Arbor. Blue Cross Blue Shield of Michigan Cardiovascular Collaborative, Ann Arbor, MI (M.S., H.S.G.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David C.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Urology (D.C.M., J.M.D., J.S.)"},{"name":"Blue Cross Blue Shield Michigan Value Collaborative, Ann Arbor, MI (D.C.M., J.M.D., J.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James M.","family":"Dupree","sequence":"additional","affiliation":[{"name":"Department of Urology (D.C.M., J.M.D., J.S.)"},{"name":"Blue Cross Blue Shield Michigan Value Collaborative, Ann Arbor, MI (D.C.M., J.M.D., J.S.)."},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor (D.S., E.A.K., B.K.N. 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