Acute MI Mortality Is Related to Medicare Costs

Incentive Payments Quality Care
Incentive Payments Quality Care
Medicare expenditure growth is linked to reduced 180-day case fatality in patients hospitalized with acute myocardial infarction.

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.

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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