Sources of Variation in Cardiovascular Care Cascades

What stages within cardiovascular care cascades account for variation in follow-up care after emergency department (ED) visits for patients at elevated cardiovascular risk?In this retrospective cohort study of 16 475 patients with an ED visit and elevated cardiovascular risk, variation in follow-up care was concentrated in the early cascade stages, particularly ordering and scheduling of testing and/or referrals; once scheduled, completion rates were high. Differences were most pronounced by health insurance type, patient language, and sex.Mapping variation across discrete care cascade stages can identify actionable intervention points to improve equity and efficiency in health care.

Corresponding Author: Annabel Z. Wang, MD, PhD, Department of Medicine, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115 (azwang@mgh.harvard.edu).

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