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Examination of cardiovascular outcomes in patients admitted for acute myocardial infarction within United States community hospitals

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TitleInfo
Title
Examination of cardiovascular outcomes in patients admitted for acute myocardial infarction within United States community hospitals
Name (type = personal)
NamePart (type = family)
Woodruff
NamePart (type = given)
Kimberly Beth
NamePart (type = date)
1972-
DisplayForm
Kimberly Woodruff
Role
RoleTerm (authority = RULIB)
author
Name (type = personal)
NamePart (type = family)
RHOADS
NamePart (type = given)
GEORGE
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GEORGE RHOADS
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
chair
Name (type = personal)
NamePart (type = family)
Marcella
NamePart (type = given)
Stephen
DisplayForm
Stephen Marcella
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
internal member
Name (type = personal)
NamePart (type = family)
Ohman-Strickland
NamePart (type = given)
Pamela
DisplayForm
Pamela Ohman-Strickland
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
internal member
Name (type = personal)
NamePart (type = family)
Xuan
NamePart (type = given)
Jianwei
DisplayForm
Jianwei Xuan
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
outside member
Name (type = corporate)
NamePart
Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
Name (type = corporate)
NamePart
Graduate School - New Brunswick
Role
RoleTerm (authority = RULIB)
school
TypeOfResource
Text
Genre (authority = marcgt)
theses
OriginInfo
DateCreated (qualifier = exact)
2014
DateOther (qualifier = exact); (type = degree)
2014-01
Place
PlaceTerm (type = code)
xx
Language
LanguageTerm (authority = ISO639-2b); (type = code)
eng
Abstract (type = abstract)
Objective: The objective of this dissertation was to examine cardiovascular (CV) outcomes in patients admitted for acute myocardial infarction (AMI) within United States (U.S.) community hospitals, focusing on three areas: impact of primary payer type among patients admitted for ST-segment elevation myocardial infarction (STEMI); effect of weekday vs. weekend admissions among STEMI hospitalizations; examination of trends in AMI type over a 10-year timeframe. Methods: We conducted retrospective cohort studies using hospital discharge data from the Nationwide Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality. Chapters 1 and 2 included the years 2005, 2008, and 2010, while Chapter 3 included the years 2000, 2005, and 2010. Results: Chapter 1 results indicated that among patients <65, those with private insurance as the primary payer type were significantly less likely to experience in-hospital mortality vs. patients with other primary forms of payment. In Chapter 2, results suggested that odds of in-hospital mortality in the overall cohort for weekday vs. weekend admissions depended on patient’s race in 2005 and 2008, with no significant difference observed in 2010; however those with comorbid diabetes had more favorable outcomes when admitted on a weekday across all years studied. In Chapter 3, we observed an approximately 54% decrease in STEMI, and 10% decrease in NSTEMI hospitalizations over the timeframe studied; however the odds of in-hospital mortality remained significantly higher for STEMI vs. NSTEMI admissions over the decade. Conclusions: Results of this research suggest the following: 1) Patients <65 who have private health insurance experience lower odds of in-hospital mortality vs. those with other primary forms of payment; 2) In recent years, admission day does not appear to impact in-hospital mortality, except in those with comorbid diabetes; and 3) The clinical presentation of AMI within U.S. community hospitals has changed over the past decade; however STEMI admissions are still associated with increased odds of in-hospital mortality vs. NSTEMI admissions.
Subject (authority = RUETD)
Topic
Public Health
RelatedItem (type = host)
TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
Identifier (type = RULIB)
ETD
Identifier
ETD_5212
PhysicalDescription
Form (authority = gmd)
electronic resource
InternetMediaType
application/pdf
InternetMediaType
text/xml
Extent
xi, 85 p. : ill.
Note (type = degree)
Ph.D.
Note (type = bibliography)
Includes bibliographical references
Note (type = statement of responsibility)
by Kimberly Beth Woodruff
Subject (authority = ETD-LCSH)
Topic
Myocardial infarction--United States
Subject (authority = ETD-LCSH)
Topic
Myocardial infarction--Complications--United States
Subject (authority = ETD-LCSH)
Topic
Hospitals--Cardiovascular services--United States
Subject (authority = ETD-LCSH)
Topic
Heart--Diseases--Patients
Subject (authority = ETD-LCSH)
Topic
Outcome assessment (Medical care)--United States
RelatedItem (type = host)
TitleInfo
Title
Graduate School - New Brunswick Electronic Theses and Dissertations
Identifier (type = local)
rucore19991600001
Location
PhysicalLocation (authority = marcorg); (displayLabel = Rutgers, The State University of New Jersey)
NjNbRU
Identifier (type = doi)
doi:10.7282/T3Q23XB3
Genre (authority = ExL-Esploro)
ETD doctoral
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Rights

RightsDeclaration (ID = rulibRdec0006)
The author owns the copyright to this work.
RightsHolder (type = personal)
Name
FamilyName
Woodruff
GivenName
Kimberly
Role
Copyright Holder
RightsEvent
Type
Permission or license
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2013-12-16 10:43:14
AssociatedEntity
Name
Kimberly Woodruff
Role
Copyright holder
Affiliation
Rutgers University. Graduate School - New Brunswick
AssociatedObject
Type
License
Name
Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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RULTechMD (ID = TECHNICAL1)
ContentModel
ETD
OperatingSystem (VERSION = 5.1)
windows xp
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