Quality of Care in the United States Territories, 1999–2012
| Autor: | Yun Wang, Marcella Nunez-Smith, Frederick A. Masoudi, Karthik Murugiah, Sudhakar V. Nuti, Orlando Rodríguez-Vilá, Harlan M. Krumholz, Sharon-Lise T. Normand, Joseph S. Ross |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Myocardial Infarction 030204 cardiovascular system & hematology Medicare Article Odds 03 medical and health sciences 0302 clinical medicine Health care medicine Humans Public Health Surveillance 030212 general & internal medicine Myocardial infarction Quality of care Aged Quality of Health Care Aged 80 and over Heart Failure business.industry Mortality rate Racial Groups Public Health Environmental and Occupational Health Pneumonia medicine.disease United States Confidence interval Health equity Hospitalization Insurance Health Reimbursement Female Health Expenditures business Demography |
| Zdroj: | Medical Care. 55:886-892 |
| ISSN: | 0025-7079 |
| Popis: | BACKGROUND Millions of Americans live in the US territories, but health outcomes and payments among Medicare beneficiaries in these territories are not well characterized. METHODS Among Fee-for-Service Medicare beneficiaries aged 65 years and older hospitalized between 1999 and 2012 for acute myocardial infarction (AMI), heart failure (HF), and pneumonia, we compared hospitalization rates, patient outcomes, and inpatient payments in the territories and states. RESULTS Over 14 years, there were 4,350,813 unique beneficiaries in the territories and 402,902,615 in the states. Hospitalization rates for AMI, HF, and pneumonia declined overall and did not differ significantly. However, 30-day mortality rates were higher in the territories for all 3 conditions: in the most recent time period (2008-2012), the adjusted odds of 30-day mortality were 1.34 [95% confidence interval (CI), 1.21-1.48], 1.24 (95% CI, 1.12-1.37), and 1.85 (95% CI, 1.71-2.00) for AMI, HF, and pneumonia, respectively; adjusted odds of 1-year mortality were also higher. In the most recent study period, inflation-adjusted Medicare in-patient payments, in 2012 dollars, were lower in the territories than the states, at $9234 less (61% lower than states), $4479 less (50% lower), and $4403 less (39% lower) for AMI, HF, and pneumonia hospitalizations, respectively (P |
| Databáze: | OpenAIRE |
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