ArticleJournal of general internal medicine2018
Barriers to Healthcare Access and Long-Term Survival After an Acute Coronary Syndrome.
Article in Journal of general internal medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 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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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.
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Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- Inpatient Trauma Care Costs in the US From 2012 to 2021.JAMA network open · 2025Article
- Impact of immigration on outcomes following acute decompensated heart failure: A retrospective cohort study.ESC heart failure · 2025Article
- Self-reported Health Service Utilization and Barriers to Care Among US Adults with a History of Post COVID-19 Condition.Journal of general internal medicine · 2025Article
- The association between maternal insurance status on maternal and neonatal outcomes in women with hypertensive disorders of pregnancy.Journal of human hypertension · 2024Article
- Association between vehicle ownership and disparities in mortality after myocardial infarction.American journal of preventive cardiology · 2023Article
- The power of partnerships: state public health department multisector collaborations in major chronic disease programme areas in the United States.Health research policy and systems · 2022Article
- There is little association between prehospital delay, persistent symptoms, and post-discharge healthcare utilization in patients evaluated for acute coronary syndrome.Applied nursing research : ANR · 2022Article
- Cardiovascular Health Metrics in Patients Hospitalized with an Acute Coronary Syndrome.The American journal of medicine · 2021Article
- Racial and Ethnic Disparities in Access to Health Care Among Adults in the United States: A 20-Year National Health Interview Survey Analysis, 1999-2018.medRxiv : the preprint server for health sciences · 2020Article
- Transportation Preferences of Patients Discharged from the Emergency Department in the Era of Ridesharing Apps.The western journal of emergency medicine · 2019Article
- Spatial Access and Willingness to Use Pre-Exposure Prophylaxis Among Black/African American Individuals in the United States: Cross-Sectional Survey.JMIR public health and surveillance · 2019Article
- When a Short-Term Outlook Is the Best Long-Term Strategy: Time-Varying Risk of Readmission After Acute Myocardial Infarction.Journal of the American Heart Association · 2018Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundBarriers to healthcare are common in the USA and may result in worse outcomes among hospital survivors of an acute coronary syndrome (ACS).
objectiveTo examine the relationship between barriers to healthcare and 2-year mortality after hospital discharge for an ACS.
designLongitudinal study.
settingSurvivors of an ACS hospitalization were recruited from 6 medical centers in central Massachusetts and Georgia in 2011-2013. PATIENTS: Study participants with a confirmed ACS reported whether they had a financial-related healthcare barrier, no usual source of care, or a transportation-related healthcare barrier around the time of hospital admission.
interventionsNone. MEASUREMENTS: Cox regression analyses calculated adjusted hazard ratios (aHRs) for 2-year all-cause mortality for the three healthcare barriers while controlling for several demographic, clinical, and psychosocial characteristics.
resultsThe mean age of study participants (n = 2008) was 62 years, 33% were women, and 77% were non-Hispanic white. One third of patients reported a financial barrier, 17% lacked a usual source of care, and 12% had a transportation barrier. Five percent (n = 100) died within 2 years after hospital discharge. Compared to patients without these barriers, those lacking a usual source of care and with barriers to transportation experienced significantly higher mortality (aHRs 1.40, 95% CI 1.30 to 1.51 and 1.46, 95% CI 1.13 to 1.89, respectively). Financial barriers were not associated with all-cause mortality (aHR 0.79, 95% CI 0.60 to 1.06). LIMITATIONS: Observational study with other unmeasured potentially confounding prognostic factors.
conclusionsAbsence of an established usual source of care and inconsistent transportation availability were associated with a higher risk for dying after an ACS. Patients with these barriers to follow-up care may benefit from more intensive follow-up and support.
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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.