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Health System Affiliation and 30-Day Readmission After Heart Attack in Black Men

Jessica H Williams1, Stephanie Jarosek2, Nathan Carroll1

  • 1Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama.

American Journal of Preventive Medicine
|January 24, 2019
PubMed

Insights

Black men experience higher readmission rates after acute myocardial infarction. Hospital system affiliation did not significantly alter this disparity in 30-day readmissions.

Area of Science:

  • Cardiology
  • Health Services Research
  • Health Disparities

Background:

  • Black patients with acute myocardial infarction (AMI) treated at minority-serving hospitals face higher readmission rates.
  • Understanding factors influencing readmission disparities is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate whether hospital system affiliation (centralized vs. decentralized) influences 30-day readmission rates for Black men following AMI.
  • To determine if hospital system type mediates the association between race and AMI readmissions.

Main Methods:

  • Utilized the Healthcare Cost and Utilization Project State Inpatient Database (2009-2013) and American Hospital Association Annual Survey of Hospitals data.
  • Conducted hierarchical logistic regressions to analyze 30-day readmission data for acute myocardial infarction among men in four states.
  • Examined the mediating role of hospital system affiliation on the race-readmission relationship.

Main Results:

  • Black men constituted 7.1% of AMI hospitalizations and 8.0% of readmissions.
  • Race was a significant predictor of 30-day readmission for AMI (AOR=1.13).
  • No significant difference in readmission odds was found based on race and hospital system type, indicating no mediation effect.

Conclusions:

  • Black men exhibit a higher likelihood of 30-day readmission after acute myocardial infarction.
  • Hospital system centralization does not appear to mediate the disparity in readmissions between Black and White men for AMI.
Abstract

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