Medicaid patients less likely than those with private insurance to receive recommended cardiac care

(CHICAGO) The quality of cardiac care for Medicaid patients lags behind the care given to those with HMOs and private insurance according to a new study. The study by Dr. James Calvin, lead study author and director of cardiology at Rush University Medical Center, found Medicaid patients were less likely to receive short term medications and to undergo invasive cardiac procedures. They also had higher in-hospital mortality rates and were less likely to receive recommended discharge care. Differences were fewer and smaller for Medicare patients.

The study is published in the November 21st issue of the Annals of Internal Medicine. In addition to Rush, study participants included Duke University Medical Center, New York University School of Medicine, Northwestern University School of Medicine, University of Cincinnati College of Medicine, and the University of North Carolina at Chapel Hill.

Researchers evaluated data from over 37,000 patients younger than 65 years of age and over 59,000 patients 65 years and older at 521 hospitals across the country. All patients had acute coronary syndromes. These symptoms occur when there is insufficient blood supply to heart muscle. If the blockage lasts long enough, the muscle dies causing a heart attack.

The study measured the use of the recommended guidelines of the American College of Cardiology and American Heart Association. Those guidelines include recommended medications within the first 24 hours, medications and dietary advice to control cholesterol levels, counseling to stop smoking, and cardiac rehabilitation programs.

When compared to patients with HMO or private insurance, Medicaid patients were less likely to receive aspirin, beta-blockers, clopidogrel, and lipid-lowering agents. Medicaid patients were also less likely to receive dietary counseling, smoking cessation counseling, and referral for cardiac rehabilitation. Gaps also existed for acute care. Delays were observed fo

Contact: Kim Waterman
Rush University Medical Center

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