# Effects of Percutaneous Coronary Intervention Lab Openings and Closures on Patients, Hospitals, and Communities

> **NIH NIH R01** · NATIONAL BUREAU OF ECONOMIC RESEARCH · 2020 · $396,588

## Abstract

OTHER PROJECT INFORMATION – Project Summary/Abstract
Effects of Percutaneous Coronary Intervention Lab Openings & Closures on Patients, Hospitals &Communities
 Access to cardiac technology such as percutaneous coronary intervention (PCI) labs is critical to
improving population health. Yet we and others have documented that the proliferation of PCI labs tends to
concentrate among affluent communities, and untimely access tends to concentrate among low-income
communities. Such differential diffusion and closure patterns across communities may widen gaps in
disparities between vulnerable communities and other communities. Moreover, proliferation of PCI labs might
lead to fewer procedures performed at each site, especially in markets that already have high PCI capacity at
baseline, which could lead to worse outcomes.
 Our primary goal is to identify how openings and closures of PCI labs affect resource allocation and
patient health in saturated and low-capacity markets, and whether these market activities disproportionately
affect vulnerable populations. Our central hypothesis is that uneven proliferation and closures of PCI facilities
affects population health through the following pathways: (1) at the community level, they cause widening gaps
in resource allocation between communities that already have high PCI capacity and those that still have
unmet need; (2) at the hospital level, they change PCI volume in such a way that could result in worse health
outcomes for patients with cardiac conditions; and (3) at the individual patient level, they redistribute patients
and widen gaps in access, treatment, and health outcomes between vulnerable and other patients. Aims 1 and
2 address the average effect of PCI lab access change among patients with different conditions (AMI and
stable CAD), while Aim 3 addresses the differential effect between vulnerable and other groups.
 We will link several major databases to address our research questions. First, the primary data with which
we will identify the patient cohort will be the 100% Medicare Provider and Analysis Review and Part B claims
between 2005 and 2014. Second, we will identify PCI lab availability using the primary data source of the
American Hospital Association (AHA) annual surveys for the same years. Third, we have obtained primary
data to identify additional hospital characteristics from the AHA surveys and the Healthcare Cost Report
Information System. Fourth, we will use 2010 U.S. Census and American Community Surveys to identify each
ZIP code community's demographic composition, and the Area Resource File for capturing additional health
care market resources at the county level. Last, we will derive two databases that identify (1) baseline PCI
capacity for each community and (2) the nearest PCI lab for each patient's ZIP code and corresponding driving
time. By providing direct evidence of how changes in PCI access affect health outcomes of patients with AMI
and stable CAD in different commu...

## Key facts

- **NIH application ID:** 9922333
- **Project number:** 5R01HL114822-08
- **Recipient organization:** NATIONAL BUREAU OF ECONOMIC RESEARCH
- **Principal Investigator:** Renee Yuen-Jan Hsia
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $396,588
- **Award type:** 5
- **Project period:** 2012-08-17 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9922333

## Citation

> US National Institutes of Health, RePORTER application 9922333, Effects of Percutaneous Coronary Intervention Lab Openings and Closures on Patients, Hospitals, and Communities (5R01HL114822-08). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/9922333. Licensed CC0.

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