Coronary artery bypass grafting at safety-net versus non-safety-net hospitals.
coronary artery bypass grafting
cost
health care disparities
outcomes
safety-net burden
socioeconomic status
Journal
JTCVS open
ISSN: 2666-2736
Titre abrégé: JTCVS Open
Pays: Netherlands
ID NLM: 101768541
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
received:
15
06
2022
revised:
19
12
2022
accepted:
04
01
2023
medline:
18
4
2023
entrez:
17
4
2023
pubmed:
18
4
2023
Statut:
epublish
Résumé
Safety-net hospitals (SNHs) provide essential services to predominantly underserved patients regardless of their ability to pay. We hypothesized that patients who underwent coronary artery bypass grafting (CABG) would have inferior observed outcomes at SNHs compared with non-SNHs but that matched cohorts would have comparable outcomes. We queried the Nationwide Readmissions Database for patients who underwent isolated CABG from 2016 to 2018. We ranked hospitals by the percentage of all admissions in which the patient was uninsured or insured with Medicaid; hospitals in the top quartile were designated as SNHs. We used propensity-score matching to mitigate the effect of confounding factors and compare outcomes between SNHs and non-SNHs. A total of 525,179 patients underwent CABG, including 96,133 (18.3%) at SNHs, who had a greater burden of baseline comorbidities (median Elixhauser score 8 vs 7; After matching, early outcomes after CABG were comparable at SNHs and non-SNHs. Improved discharge resources could reduce length of stay and curtail cost, improving the value of CABG at SNHs.
Identifiants
pubmed: 37063163
doi: 10.1016/j.xjon.2023.01.008
pii: S2666-2736(23)00017-7
pmc: PMC10091382
doi:
Types de publication
Journal Article
Langues
eng
Pagination
136-149Informations de copyright
© 2023 The Author(s).
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