RESEARCH OBJECTIVE: To identify how teaching hospitals impact outcomes including mortality, length of stay, and costs, for patients who experience a myocardial infarction (MI) during a hospital stay.
STUDY DESIGN: Retrospective analysis of data from the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS). The NIS was queried for adult patients who experienced MI and were identified using the International Classification of Diseases, 9th Edition-Clinical Modification (ICD-9-CM) diagnosis codes. Univariate statistical tests were used to compare hospital-level characteristics of patients who did and did not have a MI. Student t-tests were used to compare continuous characteristics and chi-squared tests were used to compare binary and categorical characteristics. Multivariable analyses included linear regression models for mortality, length of stay, and total costs.
POPULATION STUDIED: Adult inpatients in the NIS who had a primary diagnosis of MI and an inpatient hospitalization between 2009-2011.
PRINCIPAL FINDINGS: Preliminary analysis demonstrated 19.3% of the sample consisted of a teaching hospital (n=256). Patients admitted to a teaching hospital were younger, male, come from a more diverse racial/ethnic background, were admitted on a non-elective admission, and on an emergency basis. Those teaching hospitals were more likely to be larger-sized, more likely to be a part of a centralized network, located in an urban setting, and were private, not-for-profit entities. Patients admitted to a teaching hospital who experience MI had similar mortality risks (0.01; p=0.59). They also had a significantly longer length of stay (0.86; p<0.10) and significantly greater costs ($2,834; p<0.0001) compared to patients not admitted to a teaching hospital.
CONCLUSIONS: Patients admitted to a teaching hospital for MI events were more likely to be younger, male, and admitted on an emergency basis to larger, more centralized, urban hospitals. Admission to a teaching hospital were significantly associated with increased length of stay by almost one day in patients with an MI event, and increased total costs by $2,834.
