Changes in health insurance status and mortality in patients with acute heart failure

Introduction: Health insurance changes (HIC) can lead to coverage gaps, alter the continuity of care, potentially affecting clinical outcomes; Heart Failure (HF) is a leading contributor to hospital readmissions in the U.S. We analyzed the relationship between HIC, readmission costs and mortality in...

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Main Authors: Federico Viganego, Mark K. Meiselbach, Michael G. Fradley, Samer S. Najjar
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:American Heart Journal Plus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666602225000709
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author Federico Viganego
Mark K. Meiselbach
Michael G. Fradley
Samer S. Najjar
author_facet Federico Viganego
Mark K. Meiselbach
Michael G. Fradley
Samer S. Najjar
author_sort Federico Viganego
collection DOAJ
description Introduction: Health insurance changes (HIC) can lead to coverage gaps, alter the continuity of care, potentially affecting clinical outcomes; Heart Failure (HF) is a leading contributor to hospital readmissions in the U.S. We analyzed the relationship between HIC, readmission costs and mortality in patients with HF after a recent hospitalization. Methods: We used data from the 2019 National Readmission Database to analyze 30-day re-admission incidence, costs and mortality in hospitalized HF patients in relation to HIC. Results: Among 569,714 acute HF admissions, 4.2 % of patients (n = 4811) experienced HIC within 30 days; HIC were associated with younger age, more comorbidities, and Medicaid coverage. HIC were associated with higher readmission mortality, longer hospitalizations and increased hospital costs. Conclusion: HIC in high-risk HF patients are associated with worse clinical outcomes and higher cost burden, highlighting the need for efforts aimed at preserving continuity of coverage in this population.
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spelling doaj-art-aab2dd8a493c4744aa50414f5a83e2a22025-08-20T03:50:50ZengElsevierAmerican Heart Journal Plus2666-60222025-08-015610056710.1016/j.ahjo.2025.100567Changes in health insurance status and mortality in patients with acute heart failureFederico Viganego0Mark K. Meiselbach1Michael G. Fradley2Samer S. Najjar3MedStar Heart and Vascular Institute, Baltimore, MD, United States of America; Corresponding author at: MedStar Franklin Square Medical Center, 9105 Franklin Square Dr, Suite 209, Baltimore, MD 21237, United States of America.Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of AmericaDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of AmericaMedStar Heart and Vascular Institute, Baltimore, MD, United States of AmericaIntroduction: Health insurance changes (HIC) can lead to coverage gaps, alter the continuity of care, potentially affecting clinical outcomes; Heart Failure (HF) is a leading contributor to hospital readmissions in the U.S. We analyzed the relationship between HIC, readmission costs and mortality in patients with HF after a recent hospitalization. Methods: We used data from the 2019 National Readmission Database to analyze 30-day re-admission incidence, costs and mortality in hospitalized HF patients in relation to HIC. Results: Among 569,714 acute HF admissions, 4.2 % of patients (n = 4811) experienced HIC within 30 days; HIC were associated with younger age, more comorbidities, and Medicaid coverage. HIC were associated with higher readmission mortality, longer hospitalizations and increased hospital costs. Conclusion: HIC in high-risk HF patients are associated with worse clinical outcomes and higher cost burden, highlighting the need for efforts aimed at preserving continuity of coverage in this population.http://www.sciencedirect.com/science/article/pii/S2666602225000709Heart failureHealth insurance changesOutcomesMortalityQualityOutcomes and costs in heart failure
spellingShingle Federico Viganego
Mark K. Meiselbach
Michael G. Fradley
Samer S. Najjar
Changes in health insurance status and mortality in patients with acute heart failure
American Heart Journal Plus
Heart failure
Health insurance changes
Outcomes
Mortality
Quality
Outcomes and costs in heart failure
title Changes in health insurance status and mortality in patients with acute heart failure
title_full Changes in health insurance status and mortality in patients with acute heart failure
title_fullStr Changes in health insurance status and mortality in patients with acute heart failure
title_full_unstemmed Changes in health insurance status and mortality in patients with acute heart failure
title_short Changes in health insurance status and mortality in patients with acute heart failure
title_sort changes in health insurance status and mortality in patients with acute heart failure
topic Heart failure
Health insurance changes
Outcomes
Mortality
Quality
Outcomes and costs in heart failure
url http://www.sciencedirect.com/science/article/pii/S2666602225000709
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AT markkmeiselbach changesinhealthinsurancestatusandmortalityinpatientswithacuteheartfailure
AT michaelgfradley changesinhealthinsurancestatusandmortalityinpatientswithacuteheartfailure
AT samersnajjar changesinhealthinsurancestatusandmortalityinpatientswithacuteheartfailure