For-Profit Hospitals Tied to More 30-Day AMI Readmissions

Adults hospitalized with acute myocardial infarction (AMI) at for-profit hospitals had higher adjusted odds of unplanned readmission within 30 days than those at not-for-profit hospitals, according to a retrospective analysis published in JACC: Advances.

Investigators evaluated an estimated 4,636,970 adult nonelective AMI admissions in the Nationwide Readmissions Database from 2013 through 2022, excluding 2020. Overall, 534,576 admissions (11.5%) were followed by an unplanned 30-day readmission. For comparisons of outcomes during readmission, the researchers analyzed 399,800 patients who returned to their original hospital; 66,394 (16.6%) were treated at for-profit facilities.

Over the study period, 30-day readmission rates fell from 11.5% to 10.5% at not-for-profit hospitals (P < .001), whereas rates at for-profit hospitals changed from 13.0% to 12.7% without a statistically significant trend (P = .09). In the full index-admission cohort, for-profit status was associated with higher adjusted odds of readmission (adjusted odds ratio [aOR], 1.15; P < 0.001).

Among patients readmitted to the same hospital, for-profit status was associated with higher adjusted odds of respiratory complications (aOR, 1.11; 95% CI, 1.07-1.16), renal complications (aOR, 1.04; 95% CI, 1.01-1.08), and discharge to a destination other than home (aOR, 1.07; 95% CI, 1.03-1.11). In-hospital mortality at readmission was not significantly different (aOR, 0.97; 95% CI, 0.91-1.02).

The authors cautioned that the administrative study cannot establish causation and may miss readmissions across state lines and out-of-hospital deaths after discharge. Because a patient who dies at home before rehospitalization cannot be readmitted, unmeasured differences in postdischarge survival could affect the ownership comparison. The investigators described the findings as hypothesis-generating.

Source: Leung P IV, Rahmani J, Lai O, et al. Hospital financial structure and unplanned rehospitalization following acute myocardial infarction in the United States. JACC Adv. Published online September 11, 2026. doi:10.1016/j.jacadv.2026.103218