Key result
Uninsured status in STEMI is linked to ~7% lower odds of interfacility transfer.
Why the study?
Insurance status is associated with interfacility transfer for STEMI, but whether a facility's percutaneous coronary intervention capabilities mediate this association is unknown.
Does lack of insurance reduce the likelihood of interfacility transfer in patients with STEMI?
Cohort (n=135,358)
Yes
Does lack of insurance reduce the likelihood of interfacility transfer in patients with STEMI?
Effect estimate: aOR 0.93 (95% CI 0.88-0.98)
p-value: p=.01
After accounting for hospital PCI capabilities, uninsured patients with STEMI have significantly lower odds of being transferred from the emergency department compared to insured patients.
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May signal transfer disparities for uninsured STEMI patients; this observational finding leaves open causal mechanisms and equity interventions.
Ward et al. (2023) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=135,358). Lack of insurance vs. Insurance was evaluated on Transfer status from the presenting emergency department of a percutaneous coronary intervention-capable hospital (aOR 0.93, 95% CI 0.88-0.98, p=.01). Uninsured patients with STEMI had lower odds of experiencing interfacility transfer than those with insurance (aOR 0.93; 95% CI 0.88-0.98; P=.01).
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