IMPACT OF PATIENT CHARACTERISTICS ON SOURCE OF INPATIENT ADMISSION FOR HEART SURGERIES
Author(s)
Roy D1, Blanchette CM2
1University of North Carolina, Charlotte, Charlotte, NC, USA, 2University of North Carolina at Charlotte, Charlotte, NC, USA
OBJECTIVES: Diseases of the heart pose an extreme burden on healthcare resources in the United States. Inpatient admissions originating from the emergency room increase the burden on healthcare resources and may be indicative of disparities in access to care. This study looked at the effect of patient characteristics on the source of inpatient admission for 3 types of heart surgeries. METHODS: This study used data from the 2011 Medical Expenditure Panel Survey. Logistic regression models were used to estimate associations between patient characteristics and source of inpatient admissions for coronary-artery bypass, pacemaker implant and valve surgeries. The models were adjusted for comorbidities and the level of significance was set at 95% CI. RESULTS: There were 24 and 57 patients undergoing coronary-artery bypass and pacemaker implant surgeries, respectively. Of these 11 coronary-artery bypasses and 12 pacemaker implants were admissions originating from the emergency room. No valve surgeries originated from the emergency room. Male patients of age 55 to 70 years with middle school education and having no insurance had higher odds for having an inpatient admission originating from the emergency room for coronary-artery bypass surgery (OR 1.23, CI 0.70- 0.85; OR: 1.56, CI 1.12-2.19; OR 5.91, CI 1.32-26.32; OR 1.30, CI 0.64-0.77), when compared with those with elective admissions for the procedure. The effects were similar for non-elective pacemaker implants. CONCLUSIONS: Literature suggests that there are associations between non-elective surgical events and inpatient admissions through the emergency room. This study found that patient characteristics have an influence on the source of admission for inpatient heart surgeries. The demographic profile of patients at risk for heart surgeries originating from the emergency room is suggestive of existent disparities in terms of age, education, gender and insurance status in the population sample. More research should explore whether this translates into other healthcare services.
Conference/Value in Health Info
2014-05, ISPOR 2014, Palais des Congres de Montreal
Value in Health, Vol. 17, No. 3 (May 2014)
Code
PCV117
Topic
Health Policy & Regulatory
Topic Subcategory
Health Disparities & Equity
Disease
Cardiovascular Disorders