Medicaid Patients Receive Poorer Cardiac Care

TUESDAY, Dec. 5 (HealthDay News) -- U.S. Medicaid patients are less likely than patients with HMOs or private health insurance to receive recommended cardiac care, say researchers who analyzed data on more than 96,000 patients at 521 hospitals across the country.

All the patients had acute coronary syndrome, which occurs when there is insufficient blood supply to heart muscle. If this lack of blood supply persists, the muscle dies, and the patient suffers a heart attack.

This study found that, compared to those with HMO or private insurance, Medicaid patients were less likely to receive medications such as aspirin, beta-blockers, and lipid-lowering drugs; more likely to experience delays in having cardiac procedures; and less likely to be referred for cardiac rehabilitation, or to receive counseling about eating a healthy diet and quitting smoking.

Medicaid patients also had higher in-hospital death rates (2.9 percent vs. 1.2 percent), and their risk of death was about 30 percent higher than that of patients with HMO or private insurance, the researchers calculated.

Differences were fewer and smaller between Medicare patients and those with HMO or private insurance.

The researchers said further investigation must be done to identify the causes of these disparities and to find ways to correct them. The study was published in the journal Annals of Internal Medicine.

"On the surface, people may conclude that doctors have a bias against poor people. However, it doesn't cost a thing to tell someone to watch the salt in their diet or to quit smoking, which is really good advice to reduce heart problems," study lead author Dr. James Calvin, director of cardiology at Rush University Medical Center, said in a prepared statement.

"We need further study to determine if system problems, such as lack of computerized record keeping or not enough nurses, contribute to this disparity. Care by a non-cardiologist may also be partly responsible," Calvin said.