Despite financial challenges, safety-net hospitals provide high quality care

August 06, 2012

A Yale study of the care quality received at safety-net hospitals -- which provide care for the majority of uninsured and other vulnerable populations -- found that quality at these facilities is similar to non-safety-net hospitals. This is despite the unique financial challenges at safety-net hospitals in the face of rising costs and the potential impact of the health care law.

Published in the August issue of Health Affairs, the study was conducted by Elizabeth E. Drye, M.D., of the Yale Center for Outcomes Research and Evaluation, Joseph S. Ross, M.D., assistant professor of internal medicine at Yale School of Medicine; and colleagues. The team found that mortality and readmission outcomes for illnesses like heart failure, acute myocardial infarction, and pneumonia, were effectively identical at safety-net and non-safety-net hospitals in urban metro areas.

Safety-net hospitals -- which include both public and private urban hospitals with high Medicaid caseloads serving large numbers of low-income, uninsured, and otherwise vulnerable populations -- have historically faced greater financial strains than hospitals serving more affluent populations. This financial burden was thought to negatively affect patient death rates and readmissions, which are commonly used as indicators of care quality.

The team studied a population that included fee-for-service Medicare patients age 65 or older who were hospitalized between Jan. 1, 2006, and Dec. 31, 2008, with acute myocardial infarction, heart failure, or pneumonia. They then compared death and readmission rates at both kinds of hospitals.

"Based on these findings, safety-net hospitals are performing better than many would have expected," said Ross. "We were surprised to find that mortality and readmission rates were broadly similar across urban areas for both safety-net and non-safety-net hospitals, with differences, on average, of less than one percentage point across these three conditions. For heart failure mortality, there was no difference between the two kinds of hospitals."

The results suggest that safety-net hospitals have the potential to achieve equal, or even better, outcomes than do non-safety-net hospitals, notes Drye. "By expanding insurance coverage, the newly enacted health care law should help safety-net hospitals attain even lower readmission and mortality rates," she said.
-end-
Other authors on the study include Susannah M. Bernheim, Zhenqiu Lin, Jersey Chen, Sharon-Lise T. Normand, and Harlan M. Krumholz.

The study is supported by the National Institute on Aging; the National Heart, Lung, and Blood Institute; the American Federation of Aging Research; the National Institute on Aging; and the Centers for Medicare and Medicaid Services.

Yale University

Related Heart Failure Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Machining the heart: New predictor for helping to beat chronic heart failure
Researchers from Kanazawa University have used machine learning to predict which classes of chronic heart failure patients are most likely to experience heart failure death, and which are most likely to develop an arrhythmic death or sudden cardiac death.

Heart attacks, heart failure, stroke: COVID-19's dangerous cardiovascular complications
A new guide from emergency medicine doctors details the potentially deadly cardiovascular complications COVID-19 can cause.

Autoimmunity-associated heart dilation tied to heart-failure risk in type 1 diabetes
In people with type 1 diabetes without known cardiovascular disease, the presence of autoantibodies against heart muscle proteins was associated with cardiac magnetic resonance (CMR) imaging evidence of increased volume of the left ventricle (the heart's main pumping chamber), increased muscle mass, and reduced pumping function (ejection fraction), features that are associated with higher risk of failure in the general population

Transcendental Meditation prevents abnormal enlargement of the heart, reduces chronic heart failure
A randomized controlled study recently published in the Hypertension issue of Ethnicity & Disease found the Transcendental Meditation (TM) technique helps prevent abnormal enlargement of the heart compared to health education (HE) controls.

Beta blocker use identified as hospitalization risk factor in 'stiff heart' heart failure
A new study links the use of beta-blockers to heart failure hospitalizations among those with the common 'stiff heart' heart failure subtype.

Type 2 diabetes may affect heart structure and increase complications and death among heart failure patients of Asian ethnicity
The combination of heart failure and Type 2 diabetes can lead to structural changes in the heart, poorer quality of life and increased risk of death, according to a multi-country study in Asia.

Preventive drug therapy may increase right-sided heart failure risk in patients who receive heart devices
Patients treated preemptively with drugs to reduce the risk of right-sided heart failure after heart device implantation may experience the opposite effect and develop heart failure and post-operative bleeding more often than patients not receiving the drugs.

How the enzyme lipoxygenase drives heart failure after heart attacks
Heart failure after a heart attack is a global epidemic leading to heart failure pathology.

Novel heart pump shows superior outcomes in advanced heart failure
Severely ill patients with advanced heart failure who received a novel heart pump -- the HeartMate 3 left ventricular assist device (LVAD) -- suffered significantly fewer strokes, pump-related blood clots and bleeding episodes after two years, compared with similar patients who received an older, more established pump, according to research presented at the American College of Cardiology's 68th Annual Scientific Session.

Read More: Heart Failure News and Heart Failure Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.