急性心力衰竭患者健康保险状况的变化与死亡率
Changes in health insurance status and mortality in patients with acute heart failure.
作者信息
Viganego Federico, Meiselbach Mark K, Fradley Michael G, Najjar Samer S
机构信息
MedStar Heart and Vascular Institute, Baltimore, MD, United States of America.
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
出版信息
Am Heart J Plus. 2025 Jun 20;56:100567. doi: 10.1016/j.ahjo.2025.100567. eCollection 2025 Aug.
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 ( = 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.
引言
医疗保险变更（HIC）可能导致保险覆盖缺口，改变医疗连续性，进而可能影响临床结局；心力衰竭（HF）是美国医院再入院的主要原因。我们分析了近期住院后HF患者的HIC、再入院成本与死亡率之间的关系。
方法
我们使用2019年国家再入院数据库的数据，分析住院HF患者30天再入院发生率、成本及死亡率与HIC的关系。
结果
在569,714例急性HF入院患者中，4.2%（n = 4811）的患者在30天内经历了HIC；HIC与较年轻、更多合并症及医疗补助覆盖相关。HIC与更高的再入院死亡率、更长的住院时间及增加的住院成本相关。
结论
高危HF患者的HIC与更差的临床结局及更高的成本负担相关，凸显了努力维持该人群保险覆盖连续性的必要性。
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