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

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.