'Safety-net' facilities do as well as other hospitals with the artery procedure, researchers find
By Robert Preidt
MONDAY, Aug. 7, 2017 (HealthDay News) -- Patients who have an artery-opening procedure called percutaneous coronary intervention (PCI) have similar outcomes whether they're treated at so-called safety-net or non-safety-net hospitals, researchers say.
Safety-net hospitals, which provide care to low-income Americans who are uninsured or underinsured, tend to have fewer resources than other hospitals, the researchers said. In this study, at least 10 percent of patients who underwent PCI -- also known as angioplasty -- at safety net hospitals did not have insurance.
California researchers analyzed data from 3.7 million patients who underwent PCI at 282 safety-net hospitals and 1,134 non-safety-net hospitals between 2009 and 2015. The risk of in-hospital death was only slightly higher (4 more per 1,000 PCI procedures) at safety-net hospitals than at non-safety-net hospitals.
Patients treated at safety-net hospitals tended to be younger, had more risk factors and more often were admitted to the hospital after arriving in the emergency department because of a heart attack, according to the study published Aug. 7 in the journal JACC: Cardiovascular Interventions.
The researchers also found that both types of hospitals had similar rates of bleeding and acute kidney injury, which are complications associated with PCI.
"The patients treated at safety-net hospitals often have critical heart problems and other health issues that, in many cases, have not been adequately managed," said study senior author Dr. John Ambrose, emeritus chief of cardiology at the University of California, San Francisco in Fresno.
"Therefore, the fact that these hospitals are able to keep mortality rates low and achieve these outcomes when performing PCI -- nearly matching non-safety net hospitals -- is quite remarkable," he added in a journal news release.
Patients who rely on safety-net hospitals often have little or no ability to choose a hospital or doctor based on quality outcomes, Dr. Theodore Bass noted in an accompanying editorial.
This study is timely in light of discussions about health care legislation that could affect resources for safety-net hospitals, he added.
The U.S. National Heart, Lung, and Blood Institute has more on PCI.
SOURCE: Aug. 7, 2017, news release, JACC: Cardiovascular Interventions
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