Market reform in New Jersey and the effect on mortality from acute myocardial infarction

Health Services Research
Kevin G VolppMark V Pauly

Abstract

To determine whether mortality rates for patients with acute myocardial infarction (AMI) changed in New Jersey after implementation of the Health Care Reform Act, which reduced subsidies for hospital care for the uninsured and changed hospital payment to price competition from a rate-setting system based on hospital cost. Patient discharge data from hospitals in New Jersey and New York from 1990 through 1996 and the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS). A comparison between states over time of unadjusted and risk-adjusted mortality and cardiac procedure rates. Discharge data were obtained for 286,640 patients with the primary diagnosis of AMI admitted to hospitals in New Jersey or New York from 1990 through 1996. Records of 364,273 NIS patients were used to corroborate time trends. There were no significant differences in AMI mortality among insured patients in New Jersey relative to New York or the NIS. However, there was a relative increase in mortality of 41 to 57 percent among uninsured New Jersey patients post-reform, and their rates of expensive cardiac procedures decreased concomitantly. The introduction of hospital price competition and reductions in subsidies for hospital car...Continue Reading

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Citations

Mar 8, 2012·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Alfons Palangkaraya, Jongsay Yong
Apr 9, 2008·Health Care Management Science·Jan P ClementAskar Chukmaitov
Sep 11, 2009·Health Care Management Science·Cyril F Chang, Jennifer L Troyer
Oct 10, 2006·Journal of General Internal Medicine·Kevin G M VolppSankey V Williams
Oct 10, 2006·Journal of General Internal Medicine·Somnath Saha
Nov 23, 2007·Annual Review of Public Health·Helen Levy, David Meltzer
Jun 6, 2008·Inquiry : a Journal of Medical Care Organization, Provision and Financing·Richard C Lindrooth
Oct 13, 2011·Lancet·Allyson PollockPetra Brhlikova
Sep 9, 2005·Critical Care Medicine·John M TilfordP David Adelson
May 18, 2006·Health Services Research·Meena SeshamaniKevin G Volpp
Jul 9, 2013·Health Policy·Marina CavalieriCalogero Guccio
Jan 27, 2015·International Journal of Health Services : Planning, Administration, Evaluation·Katharine FootmanMartin McKee
Sep 14, 2016·Health Economics·Piia PekolaHennamari Mikkola
Apr 3, 2012·Medical Care Research and Review : MCRR·Amol S NavatheRichard C Lindrooth
Feb 15, 2012·Journal of Health Services Research & Policy·Martin GaynorCarol Propper
Sep 6, 2011·Journal of Health Services Research & Policy·Anita Charlesworth, Zack Cooper
Jan 11, 2007·Health Affairs·Joseph S RossHarlan M Krumholz
Oct 6, 2005·Circulation·Kevin G VolppUNKNOWN National Registry of Myocardial Infarction Investigators
Jul 22, 2005·Health Services Research·Kevin G M VolppSankey V Williams
Aug 1, 2011·The Economic Journal·Zack CooperAlistair McGuire

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