Follow up after cardiovascular hospitalizations lacking, especially among marginalized populations

Follow up after cardiovascular hospitalizations lacking, especially among marginalized populations

Abstract: https://www.acpjournals.org/doi/10.7326/M23-3475       

URL goes live when the embargo lifts     

A retrospective cohort study found that between 2010 and 2019, timely post-discharge follow-up after acute myocardial infarction (AMI) and heart failure (HF) hospitalizations increased substantially for Medicare fee-for-service beneficiaries, but many patients still not getting the follow-up they need, and racial and socioeconomic disparities have worsened. This is a significant issue because timely follow-up after cardiovascular hospitalization is recommended to improve patient outcomes. The findings are published in Annals of Internal Medicine.

Researchers from the University of Pittsburgh and Harvard Medical School analyzed CMS administrative claims for all Medicare fee-for-service beneficiaries hospitalized during the period from 2010 to 2019 to describe trends and disparities in follow up after AMI (1,678,088 hospitalizations) and HF (4,245,665 hospitalizations) hospitalizations and observation stays. Participants were analyzed for receipt of a cardiology visit within 30 days of discharge and statistical models were used to estimate changes over time overall and across 5 sociodemographic characteristics based on known disparities in cardiovascular outcomes. The researchers found that nearly 40% of patients with AMI and more than 50% of patients with HF were not seen by a cardiology clinician, and nearly 20% of patients with AMI and 30% of patients with HF were not seen by any primary care or cardiology clinician within 30 days of discharge. While rates of follow up gradually improved over the decade, disparities worsened for Asian, Black, Hispanic, and Medicaid dual-eligible patients as well as patients residing in counties with higher levels of social deprivation. These findings suggest a need for equity-informed policy and health system strategies.

Media contacts: For an embargoed PDF, please contact Angela Collom at [email protected]. To speak with the corresponding author Timothy S. Anderson, MD, MAS, please email Elaine Vitone at [email protected].