Liang Fu-Wen, Lu Tsung-Hsueh, Wu Hsin-Min, Lee Jo-Chi, Yin Wei-Hsian
The NCKU Research Center for Health Data and Department of Public Health, National Cheng Kung University, No. 1, University Road, East District, Tainan, 70101, Taiwan.
Division of Cardiology, Cheng Hsin General Hospital, No. 45, Cheng Hsin Street, Bei-Tou, Taipei, 11220, Taiwan.
BMC Cardiovasc Disord. 2017 Jun 9;17(1):149. doi: 10.1186/s12872-017-0592-4.
The volume and percentage of percutaneous coronary interventions (PCIs) performed for nonacute indications have declined in the United States since 2007. However, little is known if similar trends occurred in Taiwan.
We used data from Taiwan National Health Insurance inpatient claims to examine the regional and hospital variations in the extent of decline in the percentage of nonacute indication PCIs from 2007 to 2012.
The volume of total PCIs persistently increased from 29,032 in 2007 to 35,811 in 2010 and 37,426 in 2012. However, the volume of nonacute indication PCIs first increased from 7916 in 2007 to 9143 in 2009 and then decreased to 8666 in 2012. The percentage of nonacute indication PCIs steadily decreased from 27% in 2007 to 26% in 2009 and then to 23% in 2012, a - 15% change. The extent of decline was largest in the North region (from 27% to 21%, a - 22% change) and least in Kaopin region (from 20% to 18%, a - 13% change). Of the 71 hospitals studied, 14 did not show a decreasing trend. Five of the 14 hospitals even showed an increasing trend, with a percentage change >10% between 2007 and 2012. In 2012, 6 hospitals had a nonacute indication PCI percentage >35%.
In Taiwan, four-fifths of the hospitals showed a decline in the percentage of nonacute indication PCIs from 2007 to 2012. It is plausible that Taiwanese cardiologists would have been influenced by the recommendations of crucial US trials and guidelines.
自2007年以来，美国非急性适应症经皮冠状动脉介入治疗（PCI）的数量和百分比有所下降。然而，台湾是否出现类似趋势尚不清楚。
我们使用台湾国民健康保险住院理赔数据，研究2007年至2012年非急性适应症PCI百分比下降程度的地区和医院差异。
PCI总数持续增加，从2007年的29,032例增加到2010年的35,811例和2012年的37,426例。然而，非急性适应症PCI数量先从2007年的7916例增加到2009年的9143例，然后在2012年降至8666例。非急性适应症PCI的百分比从2007年的27%稳步下降到2009年的26%，然后在2012年降至23%，变化了-15%。下降幅度在北部地区最大（从27%降至21%，变化了-22%），在高雄地区最小（从20%降至1%，变化了-13%）。在研究的71家医院中，14家没有呈现下降趋势。这14家医院中有5家甚至呈现上升趋势，2007年至2012年期间百分比变化>10%。2012年，6家医院的非急性适应症PCI百分比>35%。
在台湾，五分之四的医院在2007年至2012年期间非急性适应症PCI的百分比有所下降。台湾心脏病专家很可能受到了美国关键试验和指南建议的影响。
