Car­diac ar­rest rates drop in Ore­gon af­ter Med­i­caid ex­pan­sion

Modern Healthcare - - REGIONAL NEWS - —Maria Castel­lucci

Af­ter Ore­gon ex­panded its Med­i­caid pro­gram in 2014, the num­ber of out-of-hos­pi­tal car­diac ar­rests among peo­ple ages 45-64 in Mult­nomah County dropped by 17%, ac­cord­ing to a study in the Jour­nal of the Amer­i­can Heart As­so­ci­a­tion.

The county, which in­cludes Port­land, Ore­gon’s largest city, has about 290,800 res­i­dents.

Peo­ple with in­sur­ance are more likely to re­ceive rou­tine, pre­ven­tive care that can mit­i­gate their risks for heart dis­ease as well as car­diac ar­rest, said Dr. Sumeet Chugh, an au­thor of the study and as­so­ciate di­rec­tor of the Cedars-Si­nai Heart In­sti­tute in Los An­ge­les.

“There is no ques­tion that hav­ing health in­sur­ance leads to a bet­ter qual­ity of life and lower mor­tal­ity, over­all,” Chugh said. “If you take a se­vere con­di­tion like car­diac ar­rest, that is mostly lethal, health in­sur­ance makes a dif­fer­ence.”

Car­diac ar­rest is the lead­ing cause of un­ex­pected death in the U.S. and af­fects about 320,000 peo­ple per year, ac­cord­ing to the Amer­i­can Heart As­so­ci­a­tion. The fa­tal­ity rate of an out-of-hos­pi­tal car­diac ar­rest is also in­cred­i­bly high, at about 70% to 90%.

The au­thors chose to fo­cus on Ore­gon be­cause the state was an early adopter of Med­i­caid ex­pan­sion, and a state study on sudden un­ex­pected deaths of­fered com­pre­hen­sive de­tails on car­diac ar­rest in­ci­dents in the Port­land area.

More mid­dle-aged Mult­nomah County res­i­dents ac­quired health in­sur­ance through Med­i­caid than other means, with an ap­prox­i­mate 6.5 per­cent­age-point in­crease af­ter Med­i­caid ex­pan­sion, from 7% to 13.5%. In­sur­ance through di­rect-purchasing rose from 8.2% to 10% in the same pe­riod.

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