• Timothy S Anderson, Robert W Yeh, Shoshana J Herzig, Edward R Marcantonio, Laura A Hatfield, Jeffrey Souza, and Bruce E Landon.
• Division of General Internal Medicine, University of Pittsburgh, and Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania (T.S.A.).
• Ann. Intern. Med. 2024 Sep 1; 177 (9): 119011981190-1198.

BackgroundTimely follow-up after cardiovascular hospitalization is recommended to monitor recovery, titrate medications, and coordinate care.ObjectiveTo describe trends and disparities in follow-up after acute myocardial infarction (AMI) and heart failure (HF) hospitalizations.DesignRetrospective cohort study.SettingMedicare.ParticipantsMedicare fee-for-service beneficiaries hospitalized between 2010 and 2019.MeasurementsReceipt of a cardiology visit within 30 days of discharge. Multivariable logistic regression models were used to estimate changes over time overall and across 5 sociodemographic characteristics on the basis of known disparities in cardiovascular outcomes.ResultsThe cohort included 1 678 088 AMI and 4 245 665 HF hospitalizations. Between 2010 and 2019, the rate of cardiology follow-up increased from 48.3% to 61.4% for AMI hospitalizations and from 35.2% to 48.3% for HF hospitalizations. For both conditions, follow-up rates increased for all subgroups, yet disparities worsened for Hispanic patients with AMI and patients with HF who were Asian, Black, Hispanic, Medicaid dual eligible, and residents of counties with higher levels of social deprivation. By 2019, the largest disparities were between Black and White patients (AMI, 51.9% vs. 59.8%, difference, 7.9 percentage points [pp] [95% CI, 6.8 to 9.0 pp]; HF, 39.8% vs. 48.7%, difference, 8.9 pp [CI, 8.2 to 9.7 pp]) and Medicaid dual-eligible and non-dual-eligible patients (AMI, 52.8% vs. 60.4%, difference, 7.6 pp [CI, 6.9 to 8.4 pp]; HF, 39.7% vs. 49.4%, difference, 9.6 pp [CI, 9.2 to 10.1 pp]). Differences between hospitals explained 7.3 pp [CI, 6.7 to 7.9 pp] of the variation in follow-up for AMI and 7.7 pp [CI, 7.2 to 8.1 pp]) for HF.LimitationGeneralizability to other payers.ConclusionEquity-informed policy and health system strategies are needed to further reduce gaps in follow-up care for patients with AMI and patients with HF.Primary Funding SourceNational Institute on Aging.

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