Usual source of care and outcomes following acute myocardial infarction.

ABSTRACT:

Background

The quality of the relationship between a patient and their usual source of care may impact outcomes, especially after an acute clinical event requiring regular follow-up.

Objective

To examine the association between the presence and strength of a usual source of care with mortality and readmission after hospitalization for acute myocardial infarction (AMI).

Design

Prospective Registry Evaluating Myocardial Infarction: Event and Recovery (PREMIER), an observational, 19-center study.

Patients

AMI patients discharged between January 2003 and June 2004.

Main measures

The strength of the usual source of care was categorized as none, weak, or strong based upon the duration and familiarity of the relationship. Main outcome measures were readmissions and mortality at 6 months and 12 months post-AMI, examined in multivariable analysis adjusting for socio-demographic characteristics, access and barriers to care, financial status, baseline risk factors, and AMI severity.

Key results

Among 2,454 AMI patients, 441 (18.0 %) reported no usual source of care, whereas 247 (10.0 %) and 1,766 (72.0 %) reported weak and strong usual sources of care, respectively. When compared with a strong usual source of care, adults with no usual source of care had higher 6-month mortality rates [adjusted hazard ratio (aHR)?=?3.15, 95 % CI, 1.79-5.52; p?ConclusionsAdults with no or weak usual sources of care have an increased risk for mortality following AMI, but not for readmission.

SUBMITTER: Spatz ES 

PROVIDER: S-EPMC4026492 | biostudies-literature | 2014 Jun

REPOSITORIES: biostudies-literature