Posters
Presenting Author Academic/Professional Position
Resident
Academic Level (Author 1)
Resident
Discipline/Specialty (Author 1)
Internal Medicine
Academic Level (Author 2)
Resident
Discipline/Specialty (Author 2)
Internal Medicine
Presentation Type
Poster
Discipline Track
Community/Public Health
Abstract Type
Research/Clinical
Abstract
Introduction: Insurance coverage may significantly affect access to timely and advanced cardiovascular therapeutic interventions within the United States. Among individuals experiencing acute myocardial infarction (AMI) accompanied by cardiogenic shock (CS), variations based on the primary payer may play a role in subsequent in-hospital outcomes. We conducted a retrospective analysis to determine whether insurance status correlates with in-hospital mortality and other outcomes among patients with AMI and CS, utilizing the NIS database.
Methods: ACS patients in the 2022 NIS were categorized as STEMI or NSTE-ACS using appropriate ICD‐10 codes. Patients with both types of ACS and cardiogenic shock were included in the analysis. Observations were stratified based on insurance. Primary outcome was in-hospital mortality and secondary outcomes included: length of stay (LOS) and total hospitalization charges (TOTCHG). Multivariate linear and logistic regression were performed using STATA 19.5.
Results: Among 38,530 adult patients with diagnosed ACS and cardiogenic shock (58% STEMI), insurance status included Medicare (60%), Medicaid (11%), private insurance (24%), and no insurance (5%). STEMI patients with no insurance had significantly higher odds of mortality versus those with private insurance (adjusted odds ratio [aOR] 2.89, 95% confidence interval [CI]: 2.04−4.09; p < 0.001). The same was not true for NSTE-ACS patients with no insurance compared to privately insured individuals (aOR 1.25, 95% CI: 0.74−2.13; p 0.40).
Additionally, both STEMI (-1.88, 95% CI: -3.53− -0.24; p = 0.02), and NSTE-ACS (-2.08, 95% CI: -3.79− -0.37; p = 0.02), patients with cardiogenic shock and no insurance had significantly lower mean LOS when compared to those with private insurance, similar results were obtained when compared to Medicare and Medicaid patients. There was no statistically significant difference between TOTCHG among subgroups after adjusting for hospital and patient level characteristics.
Conclusion: Uninsured patients with STEMI or NSTE-ACS and cardiogenic shock had significantly higher odds of mortality and lower mean LOS compared to those with private insurance, irrespective of hospital- and patient-level confounders.
Recommended Citation
Aller, Renzo and Calderon, Aura, "Impact of insurance on in-hospital mortality and other outcomes among patients with ACS and Cardiogenic Shock: a nationwide analysis from 2022." (2026). Research Symposium. 10.
https://scholarworks.utrgv.edu/somrs/2026/posters/10
Impact of insurance on in-hospital mortality and other outcomes among patients with ACS and Cardiogenic Shock: a nationwide analysis from 2022.
Introduction: Insurance coverage may significantly affect access to timely and advanced cardiovascular therapeutic interventions within the United States. Among individuals experiencing acute myocardial infarction (AMI) accompanied by cardiogenic shock (CS), variations based on the primary payer may play a role in subsequent in-hospital outcomes. We conducted a retrospective analysis to determine whether insurance status correlates with in-hospital mortality and other outcomes among patients with AMI and CS, utilizing the NIS database.
Methods: ACS patients in the 2022 NIS were categorized as STEMI or NSTE-ACS using appropriate ICD‐10 codes. Patients with both types of ACS and cardiogenic shock were included in the analysis. Observations were stratified based on insurance. Primary outcome was in-hospital mortality and secondary outcomes included: length of stay (LOS) and total hospitalization charges (TOTCHG). Multivariate linear and logistic regression were performed using STATA 19.5.
Results: Among 38,530 adult patients with diagnosed ACS and cardiogenic shock (58% STEMI), insurance status included Medicare (60%), Medicaid (11%), private insurance (24%), and no insurance (5%). STEMI patients with no insurance had significantly higher odds of mortality versus those with private insurance (adjusted odds ratio [aOR] 2.89, 95% confidence interval [CI]: 2.04−4.09; p < 0.001). The same was not true for NSTE-ACS patients with no insurance compared to privately insured individuals (aOR 1.25, 95% CI: 0.74−2.13; p 0.40).
Additionally, both STEMI (-1.88, 95% CI: -3.53− -0.24; p = 0.02), and NSTE-ACS (-2.08, 95% CI: -3.79− -0.37; p = 0.02), patients with cardiogenic shock and no insurance had significantly lower mean LOS when compared to those with private insurance, similar results were obtained when compared to Medicare and Medicaid patients. There was no statistically significant difference between TOTCHG among subgroups after adjusting for hospital and patient level characteristics.
Conclusion: Uninsured patients with STEMI or NSTE-ACS and cardiogenic shock had significantly higher odds of mortality and lower mean LOS compared to those with private insurance, irrespective of hospital- and patient-level confounders.
