Risk of non-insurance in patients with reduced AMI with Medicaid expansion

(HealthDay) – Medicaid's expansion has been badociated with a reduced risk of non-insurance in patients with acute myocardial infarction (AMI), according to a study published online Jan. 16 JAMA Cardiology.

Rishi K. Wadhera, MD, Harvard Medical School, Boston, and his colleagues conducted a retrospective cohort study to determine if uninsured, quality of care, and outcome rates were changing in patients hospitalized for AMI in States having chosen to expand Medicaid three years ago versus non-expansion. Data were included for 325,343 patients.

The researchers found that between 2012 and 2016, there had been a decrease in the number of uninsured AMI hospitalizations in the expanding states (18.0 to 8.4%), with a decrease over modest in non-expanding states (25.6 to 21.1%). Medicaid coverage increased from 7.5 to 14.4% in the growing states and from 6.2 to 6.6% in the non-expanding states. For low-income patients, in expanding states versus non-expanding states, the use of most procedures has not changed. A similar improvement in hospital mortality was observed between the states of expansion and the other states (3.2 to 2.8% vs. 3.3 to 3.0%; Interaction = 0.48).

"Among low-income adults hospitalized for an AMI, the expansion of Medicaid has not been badociated with improved quality of care or better outcomes," the authors write. "These findings suggest that current systems of care for urgent urgent conditions may be less insecure than previously recognized."

Several authors have revealed financial links with the pharmaceutical industry.

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