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Outcomes and resource utilization in ST-elevation myocardial infarction in the United States: evidence for socioeconomic disparities.

Agarwal S, Garg A, Parashar A, Jaber WA, Menon V - J Am Heart Assoc (2014)

Bottom Line: There was a significantly higher mortality among the lowest SES quartile as compared to the highest quartile (OR [95% CI]: 1.11 [1.06 to 1.17]).Furthermore, the mean adjusted cost of hospitalization among quartiles 2, 3, and 4, as compared to quartile 1 was significantly higher by $913, $2140, and $4070, respectively.The cost of hospitalization of patients from higher SES quartiles was significantly higher than those from lower quartiles.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH (S.A., W.A.J., V.M.).

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Related in: MedlinePlus

The percent incidence and adjusted odds ratio (OR) for in‐hospital death and timely reperfusion, stratified by zip‐code‐based socioeconomic quartiles after eliminating all patients who were transferred from an outside healthcare facility. All quartiles were based on median household income of the respective zip code. All comparisons were drawn with reference to the highest quartile. Quartile 1: $1 to $37 999, quartile 2: $38 000 to $47 999, quartile 3: $48 000 to $62 999, quartile 4: $63 000 or more.
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fig02: The percent incidence and adjusted odds ratio (OR) for in‐hospital death and timely reperfusion, stratified by zip‐code‐based socioeconomic quartiles after eliminating all patients who were transferred from an outside healthcare facility. All quartiles were based on median household income of the respective zip code. All comparisons were drawn with reference to the highest quartile. Quartile 1: $1 to $37 999, quartile 2: $38 000 to $47 999, quartile 3: $48 000 to $62 999, quartile 4: $63 000 or more.

Mentions: Sensitivity analysis was performed by comparing the primary outcomes between the study groups after removing all patients who presented as a “transfer” from another healthcare facility. There was no significant change in the trend of the incidence of the primary outcomes across the SES quartiles with this sensitivity analysis (Figure 2). Figure 1 also demonstrates the utilization of percutaneous assist/intra‐aortic balloon pump and Swan Ganz catheterization, stratified by SES quartiles. As seen in this figure, there was a progressively reduced utilization of both modalities among patients from lower SES quartiles as compared to higher quartiles. The incidence of cardiogenic shock accompanying STEMI in SES quartiles 1 to 4 was similar at 8.4%, 8.3%, 8.4%, and 8.8%, respectively (P‐trend: 0.08).


Outcomes and resource utilization in ST-elevation myocardial infarction in the United States: evidence for socioeconomic disparities.

Agarwal S, Garg A, Parashar A, Jaber WA, Menon V - J Am Heart Assoc (2014)

The percent incidence and adjusted odds ratio (OR) for in‐hospital death and timely reperfusion, stratified by zip‐code‐based socioeconomic quartiles after eliminating all patients who were transferred from an outside healthcare facility. All quartiles were based on median household income of the respective zip code. All comparisons were drawn with reference to the highest quartile. Quartile 1: $1 to $37 999, quartile 2: $38 000 to $47 999, quartile 3: $48 000 to $62 999, quartile 4: $63 000 or more.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4338692&req=5

fig02: The percent incidence and adjusted odds ratio (OR) for in‐hospital death and timely reperfusion, stratified by zip‐code‐based socioeconomic quartiles after eliminating all patients who were transferred from an outside healthcare facility. All quartiles were based on median household income of the respective zip code. All comparisons were drawn with reference to the highest quartile. Quartile 1: $1 to $37 999, quartile 2: $38 000 to $47 999, quartile 3: $48 000 to $62 999, quartile 4: $63 000 or more.
Mentions: Sensitivity analysis was performed by comparing the primary outcomes between the study groups after removing all patients who presented as a “transfer” from another healthcare facility. There was no significant change in the trend of the incidence of the primary outcomes across the SES quartiles with this sensitivity analysis (Figure 2). Figure 1 also demonstrates the utilization of percutaneous assist/intra‐aortic balloon pump and Swan Ganz catheterization, stratified by SES quartiles. As seen in this figure, there was a progressively reduced utilization of both modalities among patients from lower SES quartiles as compared to higher quartiles. The incidence of cardiogenic shock accompanying STEMI in SES quartiles 1 to 4 was similar at 8.4%, 8.3%, 8.4%, and 8.8%, respectively (P‐trend: 0.08).

Bottom Line: There was a significantly higher mortality among the lowest SES quartile as compared to the highest quartile (OR [95% CI]: 1.11 [1.06 to 1.17]).Furthermore, the mean adjusted cost of hospitalization among quartiles 2, 3, and 4, as compared to quartile 1 was significantly higher by $913, $2140, and $4070, respectively.The cost of hospitalization of patients from higher SES quartiles was significantly higher than those from lower quartiles.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH (S.A., W.A.J., V.M.).

Show MeSH
Related in: MedlinePlus