Medicaid beneficiaries are less likely to receive recommended care for acute coronary syndrome than those who have private health insurance, according to a study published on Tuesday in the Annals of Internal Medicine, Scripps Howard/Seattle Post-Intelligencer reports. For the study, James Calvin, director of cardiology at Rush University Medical Center, and colleagues between January 2001 and March 2005 examined the medical records of more than 37,000 acute coronary syndrome patients younger than age 65 and of more than 59,000 patients ages 65 and older at 521 hospitals nationwide. Acute coronary syndrome, which results from an inadequate blood supply to the muscles of the heart, can lead to muscle death and heart attacks. Researchers examined the medical records of participants to determine whether their care met recommendations established by the American College of Cardiology and the American Heart Association. The groups recommend that physicians administer medications to acute coronary syndrome patients within 24 hours of diagnosis, use medications and diet to control cholesterol levels, counsel patients to quit smoking and use cardiac rehabilitation programs. Study Results
According to the study, Medicaid beneficiaries were less likely to receive aspirin, beta-blockers and other blood thinning and anticholesterol medications than participants who had private health insurance. Medicaid beneficiaries also waited longer than participants who had private health insurance for initial electrocardiograms, as well as for heart catheterizations or bypass surgeries when physicians ordered those procedures, the study found. In addition, Medicaid beneficiaries had an in-hospital mortality rate of 2.9%, compared with 1.2% for participants who had private health insurance, and a 30% higher risk for death than those who had private coverage (Bowman, Scripps Howard/Seattle Post-Intelligencer, 11/21). Calvin said, “On the surface, people may conclude that doctors have a bias against poor people. However, it doesn’t cost a thing to tell someone to watch the salt in their diet or to quit smoking, which is really good advice to reduce heart problems” (Bowman, Scripps Howard/Washington Times, 11/21).
The study is available online. Note: You must have Adobe Acrobat Reader to view the study.