Disparities of Hospital Length of Stay and Procedures in Acute Myocardial Infarction Treatment

Background: Acute Myocardial Infarction (AMI) is the leading cause of death and primary disease for hospitalization in the United States. Few previous studies examined patient length of stay (LOS) and number of procedures (NOP) variations in AMI treatment for both patient and hospital level factors. This research identifies and describes important disparities in LOS and NOP based on the Nationwide Inpatient Sample. Methods: Data obtained from the Health Care Cost and Utilization Project, specifically the Nationwide Inpatient Sample (NIS) for the year 2003. A two-level hierarchical model was developed to test the patient and hospital level of NOP and LOS variations. Two procedures of Coronary Artery Bypass Graft (CABG) or Percutaneous Coronary Angioplasty (PTCA) were included in the analyses. Results: The study indicated that females have longer LOS but fewer NOP than males (p<0.001). Medicaid patients and patients without insurance tend to have fewer NOP (p<0.001). Patient insurance status was significantly associated with LOS in both procedures examined. Minority patients have longer LOS in both CABG and PTCA procedures examined (p<0.001). Patients in urban hospitals, teaching hospitals, and large hospitals tend to have longer LOS and higher NOP. Conclusion: Disparities in the particular areas examined merit attention when considering future health care policy development related to AMI treatment.