Post-myocardial-infarction quality of care among disabled Medicaid beneficiaries with and without serious mental illness

Emma E. McGinty, Elena Blasco-Colmenares, Yiyi Zhang, Susan C. dosReis, Daniel E. Ford, Donald M. Steinwachs, Eliseo Guallar, Gail L. Daumit

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The objective was to examine the association between serious mental illness and quality of care for myocardial infarction among disabled Maryland Medicaid beneficiaries. Methods: We conducted a retrospective cohort study of disabled Maryland Medicaid beneficiaries with myocardial infarction from 1994 to 2004. Cardiac procedures and guideline-based medication use were compared for persons with and without serious mental illness. Results: Of the 633 cohort members with myocardial infarction, 137 had serious mental illness. Serious mental illness was not associated with differences in receipt of cardiac procedures or guideline-based medications. Overall use of guideline-based medications was low; 30 days after the index hospitalization for myocardial infarction, 19%, 35% and 11% of cohort members with serious mental illness and 22%, 37% and 13% of cohort members without serious mental illness had any use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta-blockers and statins, respectively. Study participants with and without serious mental illness had similar rates of mortality. Overall, use of beta-blockers [hazard ratio 0.93, 95% confidence interval (CI) 0.90-0.97] and statins (hazard ratio 0.93, 95% CI 0.89-0.98) was associated with reduced risk of mortality. Conclusions: Quality improvement programs should consider how to increase adherence to medications of known benefit among disabled Medicaid beneficiaries with and without serious mental illness.

Original languageEnglish (US)
Pages (from-to)493-499
Number of pages7
JournalGeneral Hospital Psychiatry
Volume34
Issue number5
DOIs
StatePublished - Sep 1 2012

Keywords

  • Mental illness
  • Myocardial infarction
  • Quality of care

ASJC Scopus subject areas

  • Psychiatry and Mental health

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