Health Insurance and Inter Hospital Transfer of Patients with Acute Myocardial Infarction 6.3.09
•
0 likes•207 views
This study examined the association between health insurance status and inter-hospital transfer of 8,413 patients initially admitted to low-resource hospitals for acute myocardial infarction (AMI). The study found privately insured patients were more likely to be transferred to high-resource hospitals than patients with Medicaid or Medicare. Younger patients and those with private insurance had higher odds of transfer across all age groups, while female and black patients were less likely to be transferred after adjusting for clinical factors. The findings suggest non-clinical factors like insurance status influence inter-hospital transfer decisions.
![Table 1. Patients with Acute Myocardial Infarction Admitted to Low Resource Hospitals by Insurance Status and Age Insurance <55 years 55 to 64 years 65 to 74 years 75 to 84 years ≥85 years n |% transferred n |% transferred n |% transferred n |% transferred n |% transferred Medicaid 242|38 208|34.6 18|22.2 8|37.5 5|20.0 Medicare 118|28.8 268|28.7 1608|31.3 2672|20.1 1856|2.7 Private 563|41.7 686|37.0 87|46.0 51|21.6 23|0.0 ,[object Object],Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Methods ,[object Object],[object Object],Limitations ,[object Object],[object Object],Policy Implications ,[object Object],[object Object],[object Object],Background ,[object Object],[object Object],Conclusions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Results ,[object Object],[object Object],[object Object],Health Insurance and Inter-Hospital Transfer of Patients with Acute Myocardial Infarction Jason P. Lott MD MSHP, Theodore J. Iwashyna MD PhD, David A. Asch MD MBA, and Jeremy M. Kahn MD MS Division of Pulmonary, Allergy & Critical Care, Leonard Davis Institute of Health Economics, University of Pennsylvania; Division of Pulmonary and Critical Care, University of Michigan Table 2. Risk-Adjusted Odds Ratios b,c of Transfer from Low to High Resource Hospitals by Insurance Status and Age Insurance <55 years 55 to 64 years 65 to 74 years 75 to 84 years ≥85 years Medicaid 5.49 (3.90, 7.72) 5.01 (3.10, 7.17) NC NC NC Medicare 3.59 (2.26, 5.69) 3.78 (2.69, 5.32) 4.64 (3.72, 5.79) 2.98 (2.42, 3.68) 1 Private 6.43 (4.90, 8.45) 5.33 (4.11, 6.91) 8.16 (5.02, 13.28) 3.29 (1.58, 6.88) NC a Conditioned on admitting hospital and adjusted for gender, race, admission source, predicted probability of death (MediQual), and Charlson co-morbidity indicators b Values represent odds ratios (95% CIs) compared to Medicare patients ≥85 years; c All odds ratios significant at p<0.001 NC = Not calculated due to low numbers in those categories](https://image.slidesharecdn.com/kahnjeremy-healthinsuranceandinterhospitaltransferofpatientswithacutemyocardialinfarction-6-3-09-100819090742-phpapp02/85/Health-Insurance-and-Inter-Hospital-Transfer-of-Patients-with-Acute-Myocardial-Infarction-6-3-09-1-320.jpg)
