Coronary disease & ACS

Hospital Financial Structure and Unplanned Rehospitalization Following Acute Myocardial Infarction in the United States

JACC AdvPublished Nationwide Readmissions Database analysis

Authors' conclusion

For-profit status was associated with higher 30-day nonelective readmission rates and greater odds of renal and respiratory complications at readmission and nonhome discharge. These findings may inform policies addressing ownership-related disparities in AMI care.

Study context

Population
Adult nonelective acute myocardial infarction (AMI) hospitalizations in the United States, 2013 to 2022, stratified by hospital ownershipAMI admissions, 534,576 (11.5%) had an unplanned 30-day readmission, 399,800 patients readmitted to the index hospital, of whom 66,394 (16.6%) were treated at for-profit facilities
Participants
4,636,970 hospitalizations
Exposure
For-profit vs not-for-profit hospital ownership
Outcome
Unplanned 30-day readmission
Follow-up
30 days
Methodological detailsdoubly robust methodology, Cuzick nonparametric test for temporal trends
  • Doubly robust methodology
  • Cuzick nonparametric test for temporal trends

Main finding

As reported in the abstract

AMI admissions with an unplanned 30-day readmission

534,576

11.5%

Of the 399,800 patients readmitted to the index hospital, treated at for-profit facilities

66,394

16.6%

Observational data: associations, not effects.

Further findings

OutcomeFor-profitNot-for-profitAOR
Readmission rate trend over the study period · 2013 to 202213.0% to 12.7%11.5% to 10.5%
PP = 0.09P < 0.001
Adjusted outcomes, for-profit status30-day nonelective readmission · Following risk adjustment1.15
Adjusted outcomes, for-profit statusRespiratory complications at readmission · Following risk adjustment1.11
Adjusted outcomes, for-profit statusRenal complications at readmission · Following risk adjustment1.04
Adjusted outcomes, for-profit statusNonhome discharge · Following risk adjustment1.07

Rate reductions at for-profit hospitals by subgroup

Rate reductions at for-profit hospitals were limited to Medicare beneficiaries and coronary artery bypass grafting patients

Original publication

Hospital Financial Structure and Unplanned Rehospitalization Following Acute Myocardial Infarction in the United States. JACC Adv. Published 10 September 2026. doi:10.1016/j.jacadv.2026.103218

Summarised from the published abstract; every number is checked against it

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