ArticleJournal of general internal medicine2012
Insurance status, not race, is associated with mortality after an acute cardiovascular event in Maryland.
Article in Journal of general internal medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
17 citing papers in PubMed, 32 citations in OpenAlex.
- Health insurance, perceived threat, and posttraumatic stress after suspected acute coronary syndrome.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2024Observational
- In-hospital outcomes by insurance type among patients undergoing percutaneous coronary interventions for acute myocardial infarction in New South Wales public hospitals.International journal for equity in health · 2023Article
- Getting the right patient to angiography: Can we level the playing field?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- The Effect of Additional Private Health Insurance on Mortality in the Context of Universal Public Health Insurance.International journal of environmental research and public health · 2021Article
- Combining Nonclinical Determinants of Health and Clinical Data for Research and Evaluation: Rapid Review.JMIR public health and surveillance · 2019Review
- Barriers to Healthcare Access and Long-Term Survival After an Acute Coronary Syndrome.Journal of general internal medicine · 2018Article
- Association of State Medicaid Expansion With Rate of Uninsured Hospitalizations for Major Cardiovascular Events, 2009-2014.JAMA network open · 2018Article
- Use of Electronic Health Record Data to Evaluate the Impact of Race on 30-Day Mortality in Patients Admitted to the Intensive Care Unit.Journal of racial and ethnic health disparities · 2017Article
- Impact of Expanded Insurance Coverage on Racial Disparities in Vascular Disease: Insights From Massachusetts.Annals of surgery · 2016Article
- Race, Socioeconomic Status, and Life Expectancy After Acute Myocardial Infarction.Circulation · 2015Article
- Access to Care, Treatment Ambivalence, Medication Nonadherence, and Long-Term Mortality Among Severely Hypertensive African Americans: A Prospective Cohort Study.Journal of clinical hypertension (Greenwich, Conn.) · 2015Article
- Outcomes after first percutaneous coronary intervention for acute myocardial infarction according to patient funding source.BMC health services research · 2014Article
- Factors associated with appointment non-adherence among African-Americans with severe, poorly controlled hypertension.PloS one · 2014Article
- The effect of insurance status on outcomes after laparoscopic cholecystectomy.Surgical endoscopy · 2013Article
- Association of self-reported hospital discharge handoffs with 30-day readmissions.JAMA internal medicine · 2013Article
- All in a day's work: establishing rapport, making decisions, reducing disparities.Journal of general internal medicine · 2012Article
- Variation in access to pediatric surgical care among coexisting public and private providers: inguinal hernia as a model.Annals of Saudi medicineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is unclear how lack of health insurance or otherwise being underinsured contributes to observed racial disparities in health outcomes related to cardiovascular disease.
objectiveTo determine the relative risk of death associated with insurance and race after hospital admission for an acute cardiovascular event.
designProspective cohort study in three hospitals in Maryland representing different demographics between 1993 and 2007. PATIENTS: Patients with an incident admission who were either white or black, and had either private insurance, state-based insurance or were uninsured. 4,908 patients were diagnosed with acute myocardial infarction, 6,759 with coronary atherosclerosis, and 1,293 with stroke. MAIN MEASURES: Demographic and clinical patient-level data were collected from an administrative billing database and neighborhood household income was collected from the 2000 US Census. The outcome of all-cause mortality was collected from the Social Security Death Master File. KEY
resultsIn an analysis adjusted for race, disease severity, location, neighborhood household income among other confounders, being underinsured was associated with an increased risk of death after myocardial infarction (relative hazard, 1.31 [95 % CI: 1.09, 1.59]), coronary atherosclerosis (relative hazard, 1.50 [95 % CI: 1.26, 1.80]) or stroke (relative hazard, 1.25 [95 % CI: 0.91, 1.72]). Black race was not associated with an increased risk of death after myocardial infarction (relative hazard, 1.03 [95 % CI: 0.85, 1.24]), or after stroke (relative hazard, 1.18 [95 % CI: 0.86, 1.61]) and was associated with a decreased risk of death after coronary atherosclerosis (relative hazard, 0.82 [95 % CI: 0.69, 0.98]).
conclusionsRace was not associated with an increased risk of death, before or after adjustment. Being underinsured was strongly associated with death among those admitted with myocardial infarction, or a coronary atherosclerosis event. Our results support growing evidence implicating insurance status and socioeconomic factors as important drivers of health disparities, and potentially racial disparities.
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