Death rate from heart attack higher in US territories than on mainland

There is a 17% greater risk of dying after a heart attack if you are treated in a hospital located in a U.S. territory -- i.e. the U.S. Virgin Islands, Guam, Puerto Rico, American Samoa, and Northern Mariana Islands -- rather than in a hospital in the mainland United States, according to new findings published in the Archives of Internal Medicine.

The study by Yale School of Medicine researchers shows that many U.S. citizens who call the U.S. territories home, are at a major healthcare disadvantage.

Led by Marcella Nunez-Smith, M.D., assistant professor at Yale School of Medicine, the authors used data from Medicare to study all patients suffering from a heart attack who were admitted to 57 hospitals in the U.S. territories. They compared these to admitted to 4,799 hospitals in the mainland between July 2005 and June 2008. They found that the risk of death within 30 days after a was substantially higher for patients in all of the U.S. territories.

"We were shocked by these findings," said Nunez-Smith. "These are serious and substantial differences and translate into increased lives lost in the U.S. territories."

Nunez-Smith and her colleagues sought explanations for these findings by exploring whether patients overall just got sicker in the U.S. territories, but found the answer was "no."

"This work does put the spotlight on the need for increased resources in the U.S. territories to improve the quality of care," said Nunez-Smith. "One potential policy area for follow-up would be Medicare reimbursement rates. Hospitals in the U.S. territories have the lowest reimbursement rates of anywhere in the nation. We plan to do follow-up work with hospitals in the U.S. territories and to identify opportunities to improve for people who live, work and play in the U.S territories."

More information: Arch. Intern. Med. doi:10.1001/archinternmed.2011.284 (June 27, 2011).

add to favorites email to friend print save as pdf

Related Stories

High-spending hospitals may save more lives

Jan 31, 2011

Studies have shown that regions spending more on medical care, such as Miami, do not have better health outcomes than regions that spend relatively less, such as Minneapolis. However, less is known about how medical spending ...

Recommended for you

Pay-for-performance not found to impact access to CABG

Aug 27, 2014

(HealthDay)—For patients with acute myocardial infarction (AMI), treatment at pay-for-performance (P4P) hospitals is not associated with a change in the rate of coronary artery bypass graft (CABG) surgery, ...

A prescription for better stroke care

Aug 27, 2014

Stroke patients are 70 per cent more likely to continue taking their stroke prevention medications one year later if they have a prescription in hand when discharged – according to researchers at St. Michael's ...

User comments