Evidence map›Paper›PMID 37872627›Full record

ArticleInternational journal for equity in health2023

In-hospital outcomes by insurance type among patients undergoing percutaneous coronary interventions for acute myocardial infarction in New South Wales public hospitals.

Juliana de Oliveira Costa, Sallie-Anne Pearson, David Brieger, Sanja Lujic, Md Shajedur Rahman Shawon, Louisa R Jorm, Kees van Gool, Michael O Falster

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Article in International journal for equity in health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Juliana de Oliveira CostaMedicines Intelligence Research Program, School of Population Health - Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia. j.costa@unsw.edu.au.ORCID http://orcid.org/0000-0002-8355-023X
Sallie-Anne PearsonMedicines Intelligence Research Program, School of Population Health - Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia.ORCID http://orcid.org/0000-0001-7137-6855
David BriegerConcord Clinical School - The University of Sydney, Sydney, Australia.ORCID http://orcid.org/0000-0001-6115-0326
Sanja LujicCentre for Big Data Research in Health - Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia.ORCID http://orcid.org/0000-0002-9555-0261
Md Shajedur Rahman ShawonCentre for Big Data Research in Health - Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia.ORCID http://orcid.org/0000-0003-4502-1457
Louisa R JormCentre for Big Data Research in Health - Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia.ORCID http://orcid.org/0000-0003-0390-661X
Kees van GoolCentre for Health Economics Research and Evaluation - University of Technology Sydney, Sydney, Australia.ORCID http://orcid.org/0000-0002-1424-9304
Michael O FalsterMedicines Intelligence Research Program, School of Population Health - Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia.ORCID http://orcid.org/0000-0001-6444-7272

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInternational evidence suggests patients receiving cardiac interventions experience differential outcomes by their insurance status. We investigated outcomes of in-hospital care according to insurance status among patients admitted in public hospitals with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI).

methodsWe conducted a cohort study within the Australian universal health care system with supplemental private insurance. Using linked hospital and mortality data, we included patients aged 18 + years admitted to New South Wales public hospitals with AMI and undergoing their first PCI from 2017-2020. We measured hospital-acquired complications (HACs), length of stay (LOS) and in-hospital mortality among propensity score-matched private and publicly funded patients. Matching was based on socio-demographic, clinical, admission and hospital-related factors.

resultsOf 18,237 inpatients, 30.0% were privately funded. In the propensity-matched cohort (n = 10,630), private patients had lower rates of in-hospital mortality than public patients (odds ratio: 0.59, 95% CI: 0.45-0.77; approximately 11 deaths avoided per 1,000 people undergoing PCI procedures). Mortality differences were mostly driven by STEMI patients and those from major cities. There were no significant differences in rates of HACs or average LOS in private, compared to public, patients.

conclusionOur findings suggest patients undergoing PCI in Australian public hospitals with private health insurance experience lower in-hospital mortality compared with their publicly insured counterparts, but in-hospital complications are not related to patient health insurance status. Our findings are likely due to unmeasured confounding of broader patient selection, socioeconomic differences and pathways of care (e.g. access to emergency and ambulatory care; delays in treatment) that should be investigated to improve equity in health outcomes.

Indexed as

Myocardial InfarctionPercutaneous Coronary InterventionAustraliaCohort StudiesHospital MortalityHospitals, PublicHumansInsurance, HealthNew South WalesTreatment OutcomeHealthcare disparitiesHealth insuranceHospitalsMyocardial infarctionPercutaneous coronary intervention

Identifiers

PMID37872627
PMCPMC10594777

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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.