Coronary disease & ACSCohort study
The Association of Hospital-Cardiologist Integration With Patient Outcomes, Care Quality, and Utilization
- Retrospective cohort study
- difference-in-differences
Authors' conclusion
We found minimal evidence that cardiologist employment by hospitals improves care quality or outcomes.
Study context
- Population
- Medicare fee-for-service beneficiaries hospitalized with incident acute myocardial infarction (AMI) or heart failure (HF), 2008–2019AMI and HF patients per group
- Exposure
- Hospital-employed vs Independent
- Outcome
- In-hospital mortality, 30-day mortality and 30-day readmission
Main finding
As reported in the abstract
30-day mortality · 30 days
Hospital-employed vs IndependentAdjusted difference, % (95% CI)
AMI
0.03(−0.39% to 0.45%)
HF
−0.05(−0.37% to 0.27%)
Observational data: associations, not effects.
Further findings
| Outcome | adjusted difference (%) (95% CI) | |
|---|---|---|
| 30-day follow-up clinic visit (HF) | 1.04 (0.46%–1.62%) | |
| −1012Difference, % (linear scale) |
30-day follow-up clinic visit (HF)
- No differences in most quality metrics
Utilization (length of stay; coronary revascularization in AMI)
- No differences in utilization
Proportion of US cardiologists employed by hospitals
- Increased from 2008 to 2019
- 26% to 63%
Original publication
The Association of Hospital-Cardiologist Integration With Patient Outcomes, Care Quality, and Utilization. J Am Coll Cardiol. Published 15 November 2024. doi:10.1016/j.jacc.2024.10.109
Summarised from the published abstract; every number is checked against it