{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T18:31:42Z","timestamp":1780770702440,"version":"3.54.1"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>\n              Among Medicare value-based payment programs for acute myocardial infarction (AMI), the Hospital Readmissions Reduction Program uses\n              <jats:italic>International Classification of Diseases, Tenth Revision<\/jats:italic>\n              (\n              <jats:italic>ICD-10<\/jats:italic>\n              ) codes to identify the program denominator, while the Bundled Payments for Care Improvement Advanced program uses diagnosis-related groups (DRGs). The extent to which these programs target similar patients, whether they target the intended population (type 1 myocardial infarction), and whether outcomes are comparable between cohorts is not known.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>\n              In a retrospective study of 2176 patients hospitalized in an integrated health system, a cohort of patients assigned a principal\n              <jats:italic>ICD-10<\/jats:italic>\n              diagnosis of AMI and a cohort of patients assigned an AMI DRG were compared according to patient-level agreement and outcomes such as mortality and readmission.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              One thousand nine hundred thirty-five patients were included in the\n              <jats:italic>ICD-10<\/jats:italic>\n              cohort compared with 662 patients in the DRG cohort. Only 421 patients were included in both AMI cohorts (19.3% agreement). DRG cohort patients were older (70 versus 65 years,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), more often female (48% versus 30%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and had higher rates of heart failure (52% versus 33%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and kidney disease (42% versus 25%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Comparing outcomes, the DRG cohort had significantly higher unadjusted rates of 30-day mortality (6.6% versus 2.5%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), 1-year mortality (21% versus 8%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and 90-day readmission (26% versus 19%,\n              <jats:italic>P<\/jats:italic>\n              =0.006) than the\n              <jats:italic>ICD-10<\/jats:italic>\n              cohort. Two observations help explain these differences: 61% of\n              <jats:italic>ICD-10<\/jats:italic>\n              cohort patients were assigned procedural DRGs for revascularization instead of an AMI DRG, and type 1 myocardial infarction patients made up a smaller proportion of the DRG cohort (34%) than the\n              <jats:italic>ICD-10<\/jats:italic>\n              cohort (78%).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>\n              The method used to identify denominators for value-based payment programs has important implications for the patient characteristics and outcomes of the populations. As national and local quality initiatives mature, an emphasis on\n              <jats:italic>ICD-10<\/jats:italic>\n              codes to define AMI cohorts would better represent type 1 myocardial infarction patients.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.120.006570","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T10:01:31Z","timestamp":1614765691000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Acute Myocardial Infarction Cohorts Defined by\n            <i>International Classification of Diseases, Tenth Revision<\/i>\n            Versus Diagnosis-Related Groups"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9076-9619","authenticated-orcid":true,"given":"Andrew E.","family":"Levy","sequence":"first","affiliation":[{"name":"Division of Cardiology (A.E.L., K.J.M., J.D.N., J.C.M., F.A.M., L.A.A., K.S.R.), University of Colorado Anschutz Medical Campus, Aurora."},{"name":"Division of Cardiology, Denver Health and Hospital Authority, CO (A.E.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Hammes","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Informatics, Colorado School of Public Health, Aurora (A.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra L.","family":"Anoff","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine (D.L.A.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua D.","family":"Raines","sequence":"additional","affiliation":[{"name":"Department of Medicine (J.D.R., N.M.B., E.W.R., P.M.H.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie M.","family":"Beck","sequence":"additional","affiliation":[{"name":"Department of Medicine (J.D.R., N.M.B., E.W.R., P.M.H.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1738-025X","authenticated-orcid":true,"given":"Eric W.","family":"Rudofker","sequence":"additional","affiliation":[{"name":"Department of Medicine (J.D.R., N.M.B., E.W.R., P.M.H.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly J.","family":"Marshall","sequence":"additional","affiliation":[{"name":"Division of Cardiology (A.E.L., K.J.M., J.D.N., J.C.M., F.A.M., L.A.A., K.S.R.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica D.","family":"Nensel","sequence":"additional","affiliation":[{"name":"Division of Cardiology (A.E.L., K.J.M., J.D.N., J.C.M., F.A.M., L.A.A., K.S.R.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Messenger","sequence":"additional","affiliation":[{"name":"Division of Cardiology (A.E.L., K.J.M., J.D.N., J.C.M., F.A.M., L.A.A., K.S.R.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick A.","family":"Masoudi","sequence":"additional","affiliation":[{"name":"Division of Cardiology (A.E.L., K.J.M., J.D.N., J.C.M., F.A.M., L.A.A., K.S.R.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6916-7798","authenticated-orcid":true,"given":"Read G.","family":"Pierce","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dell Medical School, Austin, TX (R.G.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2540-3095","authenticated-orcid":true,"given":"Larry A.","family":"Allen","sequence":"additional","affiliation":[{"name":"Division of Cardiology (A.E.L., K.J.M., J.D.N., J.C.M., F.A.M., L.A.A., K.S.R.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1171-9171","authenticated-orcid":true,"given":"Karen S.","family":"Ream","sequence":"additional","affiliation":[{"name":"Division of Cardiology (A.E.L., K.J.M., J.D.N., J.C.M., F.A.M., L.A.A., K.S.R.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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