Previously submitted to: JMIR Public Health and Surveillance (no longer under consideration since Mar 06, 2024)
Date Submitted: Dec 10, 2023
Open Peer Review Period: Dec 10, 2023 - Dec 24, 2023
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Healthcare utilization patterns and long-term all-cause mortality after acute myocardial infarction using National Sample Cohort in Korea
ABSTRACT
Background:
Acute myocardial infarction (AMI) is a disease associated with high mortality. Therefore, patient groups with a higher risk of death should be identified, and early intervention is required to improve long-term survival rates.
Objective:
This study aims to find out the association between long-term all-cause mortality after acute myocardial infarction discharge using healthcare utilization patterns in Korea.
Methods:
This study used the National Health Insurance Service-National Sample Cohort in South Korea, 2011 to 2019. The study participants consisted of 3,535 patients who survived for 120 days after discharge following the AMI surgery. The primary outcome was all-cause mortality after 120 days from AMI discharge. The extracted patterns of healthcare utilization (health expenditure, length of stay, and number of outpatients) were divided into four groups using the latent class linear mixed model. We estimated the hazard ratios for all-cause mortality after 120 days from AMI discharge using the Cox proportional hazard model.
Results:
There were 3,535 individuals included in this study, among whom 266 (7.5%) had died and the mean (SD) age were 74.0 (10.2) years. Among the elderly population (age > 65 years), high-utilization group (HR = 1.84; p = 0.032), second-high-utilization group (HR = 1.92; p = 0.013), and reverse J-shaped utilization group (HR = 1.75; p = 0.049) had a significantly higher risk of mortality compared to the decreasing-utilization group.
Conclusions:
This study confirmed the association between healthcare utilization patterns and long-term mortality among the elderly. Therefore, healthcare utilization patterns can be considered a predictor of long-term all-cause mortality after AMI discharge.
Citation
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