Changes in health insurance status and mortality in patients with acute heart failure

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice Pub Date : 2025-06-20 DOI:10.1016/j.ahjo.2025.100567

Federico Viganego , Mark K. Meiselbach , Michael G. Fradley , Samer S. Najjar

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Abstract

Introduction

Health insurance changes (HIC) can lead to coverage gaps, alter the continuity of care, potentially affecting clinical outcomes; Heart Failure (HF) is a leading contributor to hospital readmissions in the U.S. We analyzed the relationship between HIC, readmission costs and mortality in patients with HF after a recent hospitalization.

Methods

We used data from the 2019 National Readmission Database to analyze 30-day re-admission incidence, costs and mortality in hospitalized HF patients in relation to HIC.

Results

Among 569,714 acute HF admissions, 4.2 % of patients (n = 4811) experienced HIC within 30 days; HIC were associated with younger age, more comorbidities, and Medicaid coverage. HIC were associated with higher readmission mortality, longer hospitalizations and increased hospital costs.

Conclusion

HIC in high-risk HF patients are associated with worse clinical outcomes and higher cost burden, highlighting the need for efforts aimed at preserving continuity of coverage in this population.

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急性心力衰竭患者健康保险状况和死亡率的变化

健康保险变更（HIC）可能导致覆盖缺口，改变护理的连续性，潜在地影响临床结果；在美国，心力衰竭（HF）是导致再入院的主要原因。我们分析了近期住院的心力衰竭患者的HIC、再入院费用和死亡率之间的关系。方法使用2019年国家再入院数据库的数据，分析住院HF患者与HIC相关的30天再入院发生率、成本和死亡率。结果569,714例急性心衰入院患者中，4.2% （n = 4811）在30天内发生HIC；HIC与更年轻的年龄、更多的合并症和医疗补助有关。HIC与更高的再入院死亡率、更长的住院时间和更高的住院费用相关。结论高危心衰患者的hic与较差的临床结果和较高的费用负担相关，强调了在这一人群中保持覆盖连续性的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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