The process and outcome of hospital care for Medicaid versus privately insured hospital patients.

Some have argued that low Medicaid payment rates compromise the accessibility and quality of medical care for Medicaid beneficiaries. In this study we compare the process and outcome of hospital care for Medicaid versus privately insured hospital patients. We studied 4,033 emergency patients admitted with a principal diagnosis of acute myocardial infarction, to Massachusetts hospitals in 1987. After we statistically adjusted for differences among patients relating to clinical and demographic characteristics and the type of hospital where treatment occurred, we found that the Medicaid patients had longer hospital stays but were less likely to receive three selected coronary procedures. Moreover, after controlling for confounding variables, we found the risk of death for Medicaid patients to be almost twice as high as for privately insured patients.