Abstract
Introduction: We examined the relationship between type of health insurance and all-cause readmission in the year following PCI among age-bracketed groups in a single large health system. Materials & Methods: We retrospectively reviewed data from all patients undergoing PCI at UNC-Chapel Hill Hospitals from 2015 to 2019. Patients were divided into groups based on age (<65 or 65+) and type of insurance. Multivariate logistic regression was used to assess the association between the presence of private insurance coverage and readmission rate in the year following PCI among the <65 population and the 65+ Medicare population. Results: Readmission rate was 19.0% in the <65 group and 27.12% in the ≥65 group. After adjusting for age, gender, procedural variables, and medical comorbidities, odds ratios (OR) were determined based upon reference groups of “Private” in the <65 group and “Medicare + Private” in the ≥65 group. In the <65 population, OR’s showed increased risk of readmission in all groups compared to “Private.” In the ≥65 population, OR’s showed no increase in risk of readmission between “Medicare + Private” and other groups. Conclusion: The presence of universal health care (Medicare) in the >65 population significantly reduces disparities in repeat hospital admissions following PCI that are noted in patients <65 without private insurance. Utilization of hospital readmission data coupled with NCDR Cath-PCI data is a useful tool to determine predictors of readmission.
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