Racial Disparities in Endovascular Aortic Aneurysm Repair.
Black or African American
Age Factors
Aged
Aged, 80 and over
Aortic Aneurysm
/ diagnostic imaging
Blood Vessel Prosthesis Implantation
/ economics
Comorbidity
Endovascular Procedures
/ economics
Female
Florida
/ epidemiology
Healthcare Disparities
/ economics
Hispanic or Latino
Hospital Charges
Humans
Length of Stay
Male
Medicaid
Middle Aged
Risk Factors
Sex Factors
Time Factors
Treatment Outcome
United States
White People
Journal
Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
09
04
2018
revised:
25
10
2018
accepted:
16
11
2018
pubmed:
27
11
2018
medline:
14
6
2019
entrez:
27
11
2018
Statut:
ppublish
Résumé
Racial and ethnic disparities are a critical issue in access to care within all fields of medicine. We hypothesized that analysis of a statewide administrative dataset would demonstrate disparities based on race with respect to access to this latest technology and the associated outcomes following endovascular aortic aneurysm repair (EVAR). Utilizing de-identified data from the Florida State Agency for Health Care Administration, we identified patients based on International Classification of Diseases Ninth Revision procedure codes who underwent EVAR between the years 2000 and 2014. We then assigned these procedures with the specialty of the operating physician and then analyzed outcomes based on the race of the patient. We identified 36,601 EVAR procedures during the study period. The average age of the total sample was 73.38 (±9.87), with the majority of the cohort being male (n = 29,034, 81.2%). Breakdown of patients within each race category was as follows: 17,056 (47.7%) non-Hispanic Whites, 1,630 (4.6%) non-Hispanic African Americans, 16,431 (46.0%) Hispanics, and 632 (1.8%) patients identified as "other." Data analysis showed significant differences among age at presentation, sex of patient, and comorbidity score of patients at presentation. There were significant differences in outcomes based on race with respect to total hospital charges, length of stay, disposition, and payer status. Racial disparities were discovered with respect to EVAR treatment. African Americans present at younger ages, have the highest percentage of females requiring intervention, have the longest hospital stays, have the highest Medicaid payer source, have the highest in-hospital total charges of any racial group, and are more likely to be treated by academic practitioners. Hispanics present with the highest comorbidity scores compared to their counterparts and, along with African Americans, are more likely to be treated by nonvascular surgeons.
Sections du résumé
BACKGROUND
BACKGROUND
Racial and ethnic disparities are a critical issue in access to care within all fields of medicine. We hypothesized that analysis of a statewide administrative dataset would demonstrate disparities based on race with respect to access to this latest technology and the associated outcomes following endovascular aortic aneurysm repair (EVAR).
METHODS
METHODS
Utilizing de-identified data from the Florida State Agency for Health Care Administration, we identified patients based on International Classification of Diseases Ninth Revision procedure codes who underwent EVAR between the years 2000 and 2014. We then assigned these procedures with the specialty of the operating physician and then analyzed outcomes based on the race of the patient.
RESULTS
RESULTS
We identified 36,601 EVAR procedures during the study period. The average age of the total sample was 73.38 (±9.87), with the majority of the cohort being male (n = 29,034, 81.2%). Breakdown of patients within each race category was as follows: 17,056 (47.7%) non-Hispanic Whites, 1,630 (4.6%) non-Hispanic African Americans, 16,431 (46.0%) Hispanics, and 632 (1.8%) patients identified as "other." Data analysis showed significant differences among age at presentation, sex of patient, and comorbidity score of patients at presentation. There were significant differences in outcomes based on race with respect to total hospital charges, length of stay, disposition, and payer status.
CONCLUSIONS
CONCLUSIONS
Racial disparities were discovered with respect to EVAR treatment. African Americans present at younger ages, have the highest percentage of females requiring intervention, have the longest hospital stays, have the highest Medicaid payer source, have the highest in-hospital total charges of any racial group, and are more likely to be treated by academic practitioners. Hispanics present with the highest comorbidity scores compared to their counterparts and, along with African Americans, are more likely to be treated by nonvascular surgeons.
Identifiants
pubmed: 30476598
pii: S0890-5096(18)30844-6
doi: 10.1016/j.avsg.2018.11.002
pii:
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
46-51Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.