دورية أكاديمية
Did ethno-racial disparities in access to transcatheter aortic valve replacement change over time?Central MessagePerspective
| العنوان: | Did ethno-racial disparities in access to transcatheter aortic valve replacement change over time?Central MessagePerspective |
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| المؤلفون: | Brian D. Cohen, MD, Nathan Aminpour, MS, Haijun Wang, PhD, Frank W. Sellke, MD, Waddah B. Al-Refaie, MD, FACS, Afshin Ehsan, MD |
| المصدر: | JTCVS Open, Vol 12, Iss , Pp 71-83 (2022) |
| بيانات النشر: | Elsevier, 2022. |
| سنة النشر: | 2022 |
| المجموعة: | LCC:Diseases of the circulatory (Cardiovascular) system LCC:Surgery |
| مصطلحات موضوعية: | TAVR, SAVR, race/ethnicity, disparity, hospital volume, Diseases of the circulatory (Cardiovascular) system, RC666-701, Surgery, RD1-811 |
| الوصف: | Objective: In this study we sought to evaluate whether disparate use of transcatheter aortic valve replacement (TAVR) among non-White patients has decreased over time, and if unequal access to TAVR is driven by unequal access to high-volume hospitals. Methods: From 2013 to 2017, we used the State Inpatient Database across 8 states (Ariz, Colo, Fla, Md, NC, NM, Nev, Wash) to identify 51,232 Medicare beneficiaries who underwent TAVR versus surgical aortic valve replacement. Hospitals were categorized as low- (100 per year) according to total valve procedures (TAVR + surgical aortic valve replacement). Multivariable logistic regression models with interactions were performed to determine the effect of race, time, and hospital volume on the utilization of TAVR. Results: Non-White patients were less likely to receive TAVR than White patients (odds ratio [OR], 0.77; 95% CI, 0.71-0.83). However, utilization of TAVR increased over time (OR, 1.73; 95% CI, 1.73-1.80) for the total population, with non-White patients’ TAVR use growing faster than for White patients (OR, 1.06; 95% CI, 1.00-1.12), time × race interaction, P = .034. Further, an adjusted volume-stratified time trend analysis showed that utilization of TAVR at high volume hospitals increased faster for non-White patients versus White patients by 8.6% per year (OR, 1.09; 95% CI, 1.01-1.16) whereas use at low- and medium-volume hospitals did not contribute to any decreasing utilization gap. Conclusions: This analysis shows initial low rates of TAVR utilization among non-White patients followed by accelerated use over time, relative to White patients. This narrowing gap was driven by increased TAVR utilization by non-White patients at high-volume hospitals. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2666-2736 |
| Relation: | http://www.sciencedirect.com/science/article/pii/S2666273622003047; https://doaj.org/toc/2666-2736 |
| DOI: | 10.1016/j.xjon.2022.07.009 |
| URL الوصول: | https://doaj.org/article/b100d5b052bf427abbe050368de2e661 |
| رقم الأكسشن: | edsdoj.b100d5b052bf427abbe050368de2e661 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 26662736 |
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| DOI: | 10.1016/j.xjon.2022.07.009 |