Tracking Medicare Beneficiaries Who Present to the ED with a Cardiac-Related Symptom

The purpose of this study was to examine outcomes for Medicare beneficiaries who present to an emergency department (ED) with symptoms that may indicate the need for cardiac monitoring.  We used Medicare claims from 2005 and 2006 for hospital inpatient and outpatient services and for physician services rendered to FFS Medicare beneficiaries.  We identified 32,271 and 7,959 Medicare beneficiaries with an ED visit for one of the conditions of interest in 2005 and the first quarter of 2006, respectfully.  Overall, 81% of beneficiaries we tracked survived through 2006 (or 19% died).  By comparison, 94% of all Medicare beneficiaries in the 5% sample survived through 2006. Medicare beneficiaries with an ED visit for a cardiac-related condition have higher inpatient hospitalizations and mortality rates than the general Medicare population.  Although a significant share of Medicare beneficiaries with an index ED visit had a primary care office visit in the same quarter, less than 30% of these beneficiaries had a cardiology office visit in the index quarter or in any given subsequent quarter.  Few Medicare beneficiaries who present to the ED with a condition indicating the possible need for cardiac-event or Holter monitoring receive these services in the quarter of their ED visit or in any subsequent quarter.

Services : Health Economics & Outcomes Research Expertise: