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May 2004, Vol 94, No. 5 | American Journal of Public Health 778-782
© 2004 American Public Health Association

RESEARCH AND PRACTICE

Does Supplemental Private Insurance Affect Care of Medicare Recipients Hospitalized for Myocardial Infarction?

Jing Fang, MD and Michael H. Alderman, MD

The authors are with the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.

Correspondence: Requests for reprints should be sent to Jing Fang, MD, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY 10461 (e-mail: fang{at}aecom.yu.edu).

Objectives. We sought to determine whether supplemental private insurance coverage among Medicare recipients alters patterns of health care or outcomes associated with acute myocardial infarction.

Methods. Medicare patients hospitalized after a myocardial infarction were identified from New York City hospitalization records. Patients who had only Medicare coverage were compared with those who had supplemental private or public insurance coverage.

Results. Patients with supplemental private insurance exhibited increased rates of revascularization and decreased rates of in-hospital mortality relative to patients with either Medicare only or Medicare and public insurance. Moreover, Blacks and women were less likely to undergo revascularization and exhibited higher in-hospital mortality rates.

Conclusions. Despite Medicare, private insurance coverage appears to influence the likelihood of coronary revascularization among older patients hospitalized for acute myocardial infarction.




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