Bottom Line: Lack of insurance is associated with worse care and outcomes among adults hospitalized for a heart attack. It is unclear whether states that expanded Medicaid eligibility under the Patient Protection and Affordable Care Act in 2014 had an associated improvement in quality of care and outcomes among low-income patients hospitalized with a heart attack. This observational study included 325,000 patients younger than 65 who had been hospitalized for a heart attack and found that state Medicaid expansion was associated with a significant reduction in rates of uninsurance among these patients. Quality of care and outcomes, such as risk of death and a prolonged hospital stay, didn't improve among low-income adults in expansion states compared with nonexpansion states. The registry used in this study enrolls patients who may not necessarily be representative of all hospitals in the U.S.
Authors: Karen E. Joynt Maddox, M.D., M.P.H., Washington University School of Medicine in St. Louis, and coauthors.
(doi:10.1001/jamacardio.2018.4577)
Editor's Note: The article includes conflict of interest disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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Journal
JAMA Cardiology