Associations between Subsequent Hospitalizations and Primary Ambulatory Services Utilization within the First Year...

Area of Science:

• Cardiology
• Health Services Research
• Public Health

Background:

• Healthcare resource utilization is high in the first year post-acute myocardial infarction (AMI).
• Limited data exist on the link between early post-discharge resource use and long-term mortality after AMI.

Purpose of the Study:

• To examine the association between subsequent length of in-hospital stay (SLOS) and primary ambulatory visits (PAV) in the first year post-AMI and long-term mortality.
• To identify patient groups at higher risk for mortality based on early healthcare utilization patterns.

Main Methods:

• Retrospective analysis of 8112 patients discharged after an AMI.
• Patients categorized into low, intermediate, and high SLOS groups (0-1, 2-7, ≥8 days) and low (<10) and high (≥10 visits) PAV groups.
• All-cause mortality assessed over up to 18 years of follow-up using multivariable analysis.

Main Results:

• Increased SLOS (HR 1.313-1.714) and reduced PAV (HR 1.24) were independently associated with higher long-term mortality risk (p < 0.001).
• Nearly half (49.6%) of patients died during the follow-up period.
• High hospital utilization and low ambulatory care use post-discharge were linked to increased mortality.

Conclusions:

• Long-term mortality following AMI is significantly associated with high subsequent in-hospital stays and low primary ambulatory visits within the first year.
• Interventions targeting patients with prolonged hospital stays and limited outpatient follow-up are crucial for improving post-AMI outcomes.