Acute MI Mortality Is Related to Medicare Costs
A negative correlation was seen for Medicaid growth in early PCI with 180-day case fatality.
HealthDay News — For patients hospitalized with acute myocardial infarction, Medicare expenditure growth is associated with reduced 180-day case fatality, according to a study published in JAMA Cardiology.
Donald S. Likosky, PhD, from the University of Michigan in Ann Arbor, and colleagues conducted a cross-sectional analysis of Medicare beneficiaries admitted with acute myocardial infarction from January 1, 1999, through December 31, 2000 (72,473 patients); from January 1, 2004, through December 31, 2004 (38,248 patients); from January 1, 2008, through December 31, 2008 (159,558 patients); and from January 1, 2013, through June 30, 2014 (209,614 patients).
The researchers found that in the 5% of hospitals with the most rapid expenditure growth between 1999 to 2000 and 2013 to 2014, there was a 44.1% increase in mean expenditures; mean expenditures decreased by 18.7% for the 5% of hospitals with the slowest expenditure growth. There was a negative correlation for growth in early percutaneous coronary intervention with 180-day case fatality. A positive association was seen for spending on cardiac procedures with 180-day mortality, while moderate cost-effectiveness was seen for postacute care spending. Growth in other components of spending was not linked to health improvements.
"Interventions designed to promote hospital adoption of cost-effective care could improve patient outcomes and, if accompanied by cuts in cost-ineffective care (inside and outside of the hospital setting), also reduce expenditures," the authors write.
Two authors disclosed financial ties to the medical technology industry.
Likosky DS, Van Parys J, Zhou W, et al. Association between Medicare expenditure growth and mortality rates in patients with acute myocardial infarction [published online December 20, 2017] JAMA Cardiol. doi: 10.1001/jamacardio.2017.4771