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Does the ownership of the admitting hospital make a difference? Outcomes and process of care of Medicare beneficiaries admitted with acute myocardial infarction.

Publication ,  Journal Article
Sloan, FA; Trogdon, JG; Curtis, LH; Schulman, KA
Published in: Med Care
October 2003

BACKGROUND: Concerns have been expressed about quality of for-profit hospitals and their use of expensive technologies. OBJECTIVE: To determine differences in mortality after admission for acute myocardial infarction (AMI) and in the use of low- and high-tech services for AMI among for-profit, public, and private nonprofit hospitals. STUDY DESIGN, SETTING, AND PATIENTS: Cooperative Cardiovascular Project data for 129,092 Medicare patients admitted for AMI from 1994 to 1995. MAIN OUTCOME MEASURES: Mortality at 30 days and 1 year postadmission; use of aspirin, angiotensin-converting enzyme (ACE) inhibitors, beta-blockers at discharge, thrombolytic therapy, catheterization, percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass graft (CABG) compared by ownership. RESULTS: Mortality rates at 30 days and at 1 year at for-profit hospitals were no different from those at public and private nonprofit hospitals. Without patient illness variables, nonprofit hospitals had lower mortality rates at 30 days (relative risk [RR], 0.95; 95% confidence interval [CI], 0.91-0.99) and at 1 year (RR, 0.96; 95% CI, 0.93-0.99) than did for-profit hospitals, but there was no difference in mortality between public and for-profit hospitals. Beneficiaries at nonprofit hospitals were more likely to receive aspirin (RR, 1.04; 95% CI, 1.03-1.05) and ACE inhibitors (RR, 1.05; 95% CI, 1.02-1.08) than at for-profit hospitals, but had lower rates of PTCA (RR, 0.91; 95% CI, 0.86-0.96) and CABG (RR, 0.93; 95% CI, 0.86-1.00). CONCLUSIONS: Although outcomes did not vary by ownership, for-profit hospitals were more likely to use expensive, high-tech procedures. This pattern appears to be the result of for-profit hospitals' propensity to locate in areas with demand for high-tech care for AMI.

Duke Scholars

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Published In

Med Care

DOI

ISSN

0025-7079

Publication Date

October 2003

Volume

41

Issue

10

Start / End Page

1193 / 1205

Location

United States

Related Subject Headings

  • United States
  • Socioeconomic Factors
  • Patient Admission
  • Ownership
  • Outcome and Process Assessment, Health Care
  • Myocardial Infarction
  • Medicare
  • Male
  • Humans
  • Hospitals, Private
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Sloan, F. A., Trogdon, J. G., Curtis, L. H., & Schulman, K. A. (2003). Does the ownership of the admitting hospital make a difference? Outcomes and process of care of Medicare beneficiaries admitted with acute myocardial infarction. Med Care, 41(10), 1193–1205. https://doi.org/10.1097/01.MLR.0000088569.50763.15
Sloan, Frank A., Justin G. Trogdon, Lesley H. Curtis, and Kevin A. Schulman. “Does the ownership of the admitting hospital make a difference? Outcomes and process of care of Medicare beneficiaries admitted with acute myocardial infarction.Med Care 41, no. 10 (October 2003): 1193–1205. https://doi.org/10.1097/01.MLR.0000088569.50763.15.
Sloan, Frank A., et al. “Does the ownership of the admitting hospital make a difference? Outcomes and process of care of Medicare beneficiaries admitted with acute myocardial infarction.Med Care, vol. 41, no. 10, Oct. 2003, pp. 1193–205. Pubmed, doi:10.1097/01.MLR.0000088569.50763.15.

Published In

Med Care

DOI

ISSN

0025-7079

Publication Date

October 2003

Volume

41

Issue

10

Start / End Page

1193 / 1205

Location

United States

Related Subject Headings

  • United States
  • Socioeconomic Factors
  • Patient Admission
  • Ownership
  • Outcome and Process Assessment, Health Care
  • Myocardial Infarction
  • Medicare
  • Male
  • Humans
  • Hospitals, Private