Quality of care for acute myocardial infarction at urban safety-net hospitals

Health Aff (Millwood). 2007 Jan-Feb;26(1):238-48. doi: 10.1377/hlthaff.26.1.238.

Abstract

Safety-net hospitals are experiencing increasing financial strains, possibly affecting their quality of care. We compare quality at safety-net and non-safety-net urban hospitals for Medicare beneficiaries admitted with acute myocardial infarction (AMI). Although safety-net hospitals had modestly higher risk-standardized thirty-day all-cause mortality rates and modestly lower adherence to quality-of-care performance measures than non-safety-net hospitals, there was much heterogeneity among safety-net hospitals and substantial overlap with non-safety-net hospitals. We examine the implications of these findings for the millions of vulnerable Americans who rely on safety-net hospitals for their care.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Female
  • Health Care Surveys
  • Health Services Accessibility / economics*
  • Hospital Mortality
  • Hospitals, Urban / classification
  • Hospitals, Urban / economics
  • Hospitals, Urban / standards*
  • Humans
  • Male
  • Medicare / legislation & jurisprudence
  • Medicare / standards*
  • Myocardial Infarction / economics
  • Myocardial Infarction / mortality
  • Myocardial Infarction / therapy*
  • Patient Admission / statistics & numerical data
  • Patient Transfer / statistics & numerical data
  • Prospective Payment System / legislation & jurisprudence
  • Quality of Health Care / statistics & numerical data*
  • Reimbursement, Disproportionate Share / legislation & jurisprudence*
  • Retrospective Studies
  • Risk Assessment
  • United States / epidemiology
  • Vulnerable Populations*