ArticleBMJ (Clinical research ed.)2013
Income inequality and 30 day outcomes after acute myocardial infarction, heart failure, and pneumonia: retrospective cohort study.
Article in BMJ (Clinical research ed.), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
58 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Socio-economic inequalities and heart failure morbidity and mortality: A systematic review and data synthesis.ESC heart failure · 2025Pooled it
- Influence of socioeconomic factors on hospital readmissions for heart failure and acute myocardial infarction in patients 65 years and older: evidence from a systematic review.Clinical interventions in aging · 2015Pooled it
- Article
- Impact of Socioeconomic Status on Mortality and Readmission in Patients With Heart Failure With Reduced Ejection Fraction: The ARIC Study.Journal of the American Heart Association · 2022Article
- Racial Disparities in 7-Day Readmissions from an Adult Hospital Medicine Service.Journal of racial and ethnic health disparities · 2022Article
- Public Access Defibrillators and Socioeconomic Factors on the Small—Scale Spatial Level in Berlin—a Cross-Sectional AnalysisDeutsches Arzteblatt international · 2022Article
- Frequency and timing of emergency department visits and hospital admissions in stented patients following common stone procedures.Urolithiasis · 2022Article
- Article
- Socio-economic status and 1 year mortality among patients hospitalized for heart failure in China.ESC heart failure · 2022Article
- Readmissions performance and penalty experience of safety-net hospitals under Medicare's Hospital Readmissions Reduction Program.BMC health services research · 2022Article
- Autologous Breast Reconstruction is Associated with Lower 90-day Readmission Rates.Plastic and reconstructive surgery. Global open · 2022Article
- County-Level Socioeconomic Status Adjustment of Acute Myocardial Infarction Mortality Hospital Performance Measure in the U.S.Healthcare (Basel, Switzerland) · 2021Article
- Man vs. Machine: Comparing Physician vs. Electronic Health Record-Based Model Predictions for 30-Day Hospital Readmissions.Journal of general internal medicine · 2021Article
- Article
- Area Deprivation Index and Cardiac Readmissions: Evaluating Risk-Prediction in an Electronic Health Record.Journal of the American Heart Association · 2021Observational
- Psychological stress in heart failure: a potentially actionable disease modifier.Heart failure reviews · 2021Review
- Predictive Model Based on Health Data Analysis for Risk of Readmission in Disease-Specific Cohorts.Perspectives in health information managemen · 2021Article
- Article
- The Burden of Community-Acquired Pneumonia Requiring Admission to ICU in the United States.Chest · 2020Article
- Incidence, reasons, and risk factors for 30-day readmission after lumbar spine surgery for degenerative spinal disease.Scientific reports · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectivesTo examine the association between income inequality and the risk of mortality and readmission within 30 days of hospitalization.
designRetrospective cohort study of Medicare beneficiaries in the United States. Hierarchical, logistic regression models were developed to estimate the association between income inequality (measured at the US state level) and a patient's risk of mortality and readmission, while sequentially controlling for patient, hospital, other state, and patient socioeconomic characteristics. We considered a 0.05 unit increase in the Gini coefficient as a measure of income inequality.
settingUS acute care hospitals.
participantsPatients aged 65 years and older, and hospitalized in 2006-08 with a principal diagnosis of acute myocardial infarction, heart failure, or pneumonia.
main outcome measuresRisk of death within 30 days of admission or rehospitalization for any cause within 30 days of discharge. The potential number of excess deaths and readmissions associated with higher levels of inequality in US states in the three highest quarters of income inequality were compared with corresponding data in US states in the lowest quarter.
resultsMortality analyses included 555,962 admissions (4348 hospitals) for acute myocardial infarction, 1,092,285 (4484) for heart failure, and 1,146,414 (4520); readmission analyses included 553,037 (4262), 1,345,909 (4494), and 1,345,909 (4524) admissions, respectively. In 2006-08, income inequality in US states (as measured by the average Gini coefficient over three years) varied from 0.41 in Utah to 0.50 in New York. Multilevel models showed no significant association between income inequality and mortality within 30 days of admission for patients with acute myocardial infarction, heart failure, or pneumonia. By contrast, income inequality was associated with rehospitalization (acute myocardial infarction, risk ratio 1.09 (95% confidence interval 1.03 to 1.15), heart failure 1.07 (1.01 to 1.12), pneumonia 1.09 (1.03 to 1.15)). Further adjustment for individual income and educational achievement did not significantly attenuate these findings. Over the three year period, we estimate an excess of 7153 (2297 to 11,733) readmissions for acute myocardial infarction, 17,991 (3410 to 31,772) for heart failure, and 14,127 (4617 to 23,115) for pneumonia, that are associated with inequality levels in US states in the three highest quarters of income inequality, compared with US states in the lowest quarter.
conclusionsAmong patients hospitalized with acute myocardial infarction, heart failure, and pneumonia, exposure to higher levels of income inequality was associated with increased risk of readmission but not mortality. In view of the observational design of the study, these findings could be biased, owing to residual confounding.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.