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Costs in medicine continue to attract considerable attention. A central issue is whether the growth in spending has yielded commensurate benefits for patients. To address this issue for the care of patients with acute myocardial infarction (AMI), investigators studied random samples of 479,893 fee-for-service Medicare beneficiaries from 1999 through 2014. The primary outcome was 180-day case fatality, and the exposure variables were price-standardized Medicare payments for the index admission and for post–index date service utilization up to 180 days afterwards.
Case fatality declined from 26.9% in 1999–2000 to 21.5% in 2013–2014. The overall inflation- and risk-adjusted 180-day mean expenditures per patient grew by 13.9% from 1999–2000 to 2…