Document Detail


Underuse of invasive procedures among Medicaid patients with acute myocardial infarction.
MedLine Citation:
PMID:  11441735     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to determine whether underuse of cardiac procedures among Medicaid patients with acute myocardial infarction is explained by or is independent of fundamental differences in age, race, or sex distribution; income, coexistent illness; or location of care. METHODS: Administrative data from 226 hospitals in New York were examined for 11,579 individuals hospitalized with a primary diagnosis of acute myocardial infarction. Use of various cardiac procedures was compared among Medicaid patients and patients with other forms of insurance. RESULTS: Medicaid patients were older, were more frequently African American and female, and had lower median household incomes. They also had a higher prevalence of hypertension, diabetes, lung disease, renal disease, and peripheral vascular disease. After adjustment for these and other factors, Medicaid patients were less likely to undergo cardiac catheterization, percutaneous transluminal coronary angioplasty, and any revascularization procedure. CONCLUSIONS: Factors other than age, race, sex, income, coexistent illness, and location of care account for lower use of invasive procedures among Medicaid patients. The influence of Medicaid insurance on medical practice and process of care deserves investigation.
Authors:
E F Philbin; P A McCullough; T G DiSalvo; G W Dec; P L Jenkins; W D Weaver
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American journal of public health     Volume:  91     ISSN:  0090-0036     ISO Abbreviation:  Am J Public Health     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-07-09     Completed Date:  2001-07-26     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  1254074     Medline TA:  Am J Public Health     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1082-8     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Albany Medical College, (Mail Code 44), 47 New Scotland Ave, Albany, NY 12208, USA. philbie@mail.amc.edu
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary / economics,  utilization*
Comorbidity
Coronary Artery Bypass / economics,  utilization*
Female
Health Services Misuse / economics,  statistics & numerical data*
Health Services Research
Heart Catheterization / economics,  utilization*
Hospital Charges / statistics & numerical data
Hospital Mortality
Humans
Income / statistics & numerical data
Insurance, Health / economics,  utilization*
Length of Stay / economics,  statistics & numerical data
Male
Medicaid / economics,  utilization*
Middle Aged
Myocardial Infarction / economics*,  mortality,  surgery*
New York / epidemiology
Patient Discharge / economics,  statistics & numerical data
Patient Readmission / economics,  statistics & numerical data
Physician's Practice Patterns / economics,  statistics & numerical data
Retrospective Studies
Socioeconomic Factors
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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