Higher Myocardial Infarction Care Payments Improve Mortality
THURSDAY, March 22, 2018 -- Higher 30-day payments for acute myocardial infarction (AMI) care for both inpatient care and in multiple settings after discharge are associated with lower 30-day mortality among Medicare beneficiaries, according to a study published online March 12 in Circulation: Cardiovascular Quality and Outcomes.
Rishi K. Wadhera, M.D., from Brigham and Women's Hospital in Boston, and colleagues used Medicare claims data to identify 642,105 Medicare fee-for-service beneficiaries at least 65 years old who were hospitalized at an acute-care hospital for AMI between July 1, 2011, and June 30, 2014. The association between hospital-level 30-day payments for an episode of AMI care and patient 30-day mortality was assessed.
The researchers found that overall mean 30-day episode payments per beneficiary were $22,128, and the observed 30-day mortality rate was 12.9 percent. After adjusting for patient characteristics and comorbidities, higher 30-day payments were associated with lower 30-day mortality (P < 0.001). Additional adjustment for hospital characteristics, coronary revascularization rates, and discharge disposition did not significantly attenuate the relationship (P < 0.001).
"Higher hospital-level 30-day payments -- both inpatient and in multiple settings after discharge -- for AMI care were associated with lower 30-day mortality among beneficiaries," the authors write. "This may have implications for payment programs that incent reduction in payments without considering value."
Several authors disclosed financial ties to the pharmaceutical industry.
Abstract/Full Text (subscription or payment may be required): circoutcomes.ahajournals.org/content/11/3/e004397
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Posted: March 2018