1. Race and Timeliness of Transfer for Revascularization in Patients With Acute Myocardial Infarction
- Author
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John D. Birkmeyer, Brahmajee K. Nallamothu, Theodore J. Iwashyna, Colin R. Cooke, and Jeremy M. Kahn
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Hospitals, Rural ,medicine.medical_treatment ,Myocardial Infarction ,Medicare ,Revascularization ,White People ,Article ,Hospitals, Urban ,Interquartile range ,Internal medicine ,Myocardial Revascularization ,medicine ,Humans ,In patient ,Myocardial infarction ,Healthcare Disparities ,Aged ,Aged, 80 and over ,business.industry ,Mortality rate ,Racial Groups ,Public Health, Environmental and Occupational Health ,Length of Stay ,Middle Aged ,medicine.disease ,Coronary revascularization ,United States ,Confidence interval ,Black or African American ,Socioeconomic Factors ,Emergency medicine ,Cardiology ,Female ,business ,Urban hospital - Abstract
OBJECTIVES Patients with acute myocardial infarction (AMI) who are admitted to hospitals without coronary revascularization are frequently transferred to hospitals with this capability. We sought to determine whether the timeliness of hospital transfer and quality of destination hospitals differed between black and white patients. METHODS We evaluated all white and black Medicare beneficiaries admitted with AMI at nonrevascularization hospitals in 2006 who were transferred to a revascularization hospital. We compared hospital length of stay before transfer and the transfer destination's 30-day risk-standardized mortality rate for AMI between black and white patients. We used hierarchical regression to adjust for patient characteristics and examine within and across-hospital effects of race on 30-day mortality and length of stay before transfer. RESULTS A total of 25,947 (42%) white and 2345 (37%) black patients with AMI were transferred from 857 urban and 774 rural nonrevascularization hospitals to 928 revascularization hospitals. Median (interquartile range) length of stay before transfer was 1 day (1 to 3 d) for white patients and 2 days (1 to 4 d) for black patients (P
- Published
- 2011