Affiliation:
1. Division of Cardiovascular Medicine, Department of Medicine University of Wisconsin School of Medicine and Public Health Madison WI
2. William S. Middleton Memorial Veterans Hospital Madison WI
3. Division of Hospitalist Medicine, Department of Medicine University of Wisconsin School of Medicine and Public Health Madison WI
4. Division of Rheumatology, Department of Medicine University of Wisconsin School of Medicine and Public Health Madison WI
5. Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health Madison WI
6. Division of Geriatric Medicine, Department of Medicine University of Wisconsin School of Medicine and Public Health Madison WI
Abstract
Background
Ventricular tachycardia (VT) ablation significantly improves our ability to control VT, yet little is known about whether disparities exist in delivery of this technology.
Methods and Results
Using a national 100% Medicare inpatient data set of beneficiaries admitted with VT from January 1, 2014, through November 30, 2014, multivariable logistic regression techniques were used to examine the sociodemographic and clinical characteristics associated with receiving ablation. Census block group‐level neighborhood socioeconomic disadvantage was measured for each patient by the Area Deprivation Index, a composite measure of socioeconomic disadvantage consisting of education, income, housing, and employment factors. Among 131 645 patients admitted with VT, 2190 (1.66%) received ablation. After adjustment for comorbidities, hospital characteristics, and sociodemographics, female sex (odds ratio [OR], 0.75 [95% CI, 0.67–0.84]), identifying as Black race (OR, 0.75 [95% CI, 0.62–0.90] compared with identifying as White race), and living in a highly socioeconomically disadvantaged neighborhood (national Area Deprivation Index percentile of >85%) (OR, 0.81 [95% CI, 0.69–0.95] versus Area Deprivation Index ≤85%) were associated with significantly lower odds of receiving ablation.
Conclusions
Female patients, patients identifying as Black race, and patients living in the most disadvantaged neighborhoods are 19% to 25% less likely to receive ablation during hospitalization with VT. The cause of and solutions for these disparities require further investigation.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
3 articles.
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