Social determinants of health affect unplanned readmissions following acute myocardial infarction

J Comp Eff Res. 2021 Jan;10(1):39-54. doi: 10.2217/cer-2020-0135. Epub 2021 Jan 13.


Background: Low socioeconomic status predicts inferior clinical outcomes in many patient populations. The effects of patient insurance status and hospital safety-net status on readmission rates following acute myocardial infarction are unclear. Materials & methods: A retrospective review of State Inpatient Databases for New York, California, Florida and Maryland, 2007-2014. Results: A total of 1,055,162 patients were included. Medicaid status was associated with 37.7 and 44.0% increases in risk-adjusted readmission odds at 30 and 90 days (p < 0.0001). Uninsured status was associated with reduced odds of readmission at both time points. High-burden safety-net status was associated with 9.6 and 9.5% increased odds of readmission at 30 and 90 days (p < 0.0003). Conclusion: Insurance status and hospital safety-net burden affect readmission odds following acute myocardial infarction.

Keywords: cardiovascular disease; clinical outcomes; healthcare disparities.

MeSH terms

  • Florida / epidemiology
  • Humans
  • Maryland
  • Myocardial Infarction* / epidemiology
  • Myocardial Infarction* / therapy
  • New York / epidemiology
  • Patient Readmission*
  • Retrospective Studies
  • Risk Factors
  • Social Determinants of Health
  • United States / epidemiology