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Trends in Heart Attack Treatment and Outcomes, 1975–1995

Trends in Heart Attack Treatment and Outcomes, 1975–1995

Literature Review and Synthesis

(p.363) 9 Trends in Heart Attack Treatment and Outcomes, 1975–1995
Medical Care Output and Productivity
Paul HeidenreichMark McClellan
University of Chicago Press

Age-adjusted mortality rates for ischemic heart disease have fallen for the last thirty years. The reasons for the decline — which include primary prevention of coronary events, secondary prevention, improved outcomes of the events themselves, and changes in event severity — have been the subject of considerable debate. Much of the debate centers on the relative importance of medical technology versus lifestyle changes or other sources of reductions in risk factors. The debate has important implications for priorities in health care research and policymaking: if medical interventions have been relatively unimportant, then the direction of more resources to research and education on preventive care may be worthwhile. Using evidence from the clinical literature and a range of empirical databases, this chapter looks at the impact of particular changes in medical treatment in acute myocardial infarction (AMI) or heart attacks over the last two decades. It first discusses trends in disease incidence, medical treatments, and thirty-day mortality before estimating the overall cost-effectiveness of all AMI treatments combined.

Keywords:   mortality, acute myocardial infarction, medical treatments, cost-effectiveness, health care, disease incidence, heart attacks

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