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Data from the American Hospital Association’s Annual Survey of Hospitals, which are used to produce the AHA Guide, Hospital Statistics, and other data products, are widely used by hospital administrators, academic researchers, and healthcare marketers. Although they are widely used, many who use data from the survey are unaware of their limitations and problems. Such problems include: inaccuracies and inconsistencies in reporting; low response rates to certain data items; biases in reporting; and a lack of publicly available technical documentation concerning the statistical methodology of the survey, particularly its estimation and imputation procedures for missing data. Failure to be sophisticated consumers of data products can misdirect the outcome of important planning and marketing efforts.

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.