The number of uninsured has increased during recent years. This study explores underlying factors associated with the insurance-status disparities in hospital care by examining 80,730 acute myocardial infarction discharges in the National Inpatient Sample. Compared to patients having private insurance, Medicaid patients’ higher mortality risk related to severity of illness while the higher mortality of uninsured patients related to interactive effects between insurance status and hospital characteristics. Primary care strategies are likely to improve the hospital care for Medicaid patients while ensuring access to high quality care for patients with limited financial means can improve outcomes for uninsured patients.

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