Relationship between Patient Income Level and Mitral Valve Repair Utilization

Vassileva, Christina M.; Boley, Theresa M.; Standard, Joseph; Markwell, Stephen; Hazelrigg, Stephen R.

doi:10.1532/hsf98.20121105

Cited by 9 publications

(3 citation statements)

References 20 publications

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“… 24 Income level affects the rate at which patients seek health care, with one study finding patients in low-income brackets with mitral regurgitation less likely to pursue mitral valve repair. 25 Patients with low income have significantly lower rates of stoma closure following ostomy. This discrepancy was attributed to a lack of access to proper care and follow-up.…”

Section: Discussionmentioning

confidence: 99%

After Anterior Cruciate Ligament Injury, Patients With Medicaid Insurance Experience Delayed Care and Worse Clinical Outcomes Than Patients With Non-Medicaid Insurance

Kingery,

Kaplan,

Resad

et al. 2023

Arthroscopy, Sports Medicine, and Rehabilitation

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Section: Discussionmentioning

confidence: 99%

After Anterior Cruciate Ligament Injury, Patients With Medicaid Insurance Experience Delayed Care and Worse Clinical Outcomes Than Patients With Non-Medicaid Insurance

Kingery,

Kaplan,

Resad

et al. 2023

Arthroscopy, Sports Medicine, and Rehabilitation

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“…40,41 Medicaid and uninsured patients report higher perceived discrimination in healthcare settings compared with patients with private insurance and are more likely to demonstrate reduced access to care. 42,43 Objective data indicate that Black patients are less likely to be referred for appropriate surgical management of coronary artery disease and that non-White and less wealthy patients are more likely to undergo mitral valve replacement as opposed to repair, compared with their more affluent White counterparts 39,44 ; these patterns may also reflect provider bias. Beyond individual providers, differences in institutional practice patterns may be relevant to the transfusion disparities observed in the current study.…”

Section: Discussionmentioning

confidence: 99%

Medicare and Medicaid insurance status is associated with increased allogeneic red blood cell transfusion in cardiac surgery patients: 2007–2018

O'Shaughnessy

Tangel

Chaturvedi

et al. 2022

Journal of Cardiac Surgery

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Background and Aim: Allogeneic red blood cell (RBC) transfusion and health insurance status are independently associated with perioperative morbidity. The aim of this study was to evaluate the effect of insurance status on allogeneic and autologous transfusion risk in cardiac surgery patients. Methods:We conducted a retrospective observational study of data spanning 2007-2018 from six states from the State Inpatient Databases. Patients were cohorted by medical insurance type. Rates and risk-adjusted odds ratios (aOR) were calculated for allogenic and autologous RBC transfusions. Interactions between insurance and race/ethnicity were assessed.Results: A total of 710,296 cardiac surgery patients were included. Allogeneic infusions occurred in 34.7% of Medicare patients, 31.9% of Medicaid patients, 24.7% of privately insured patients, and 26.1% of uninsured patients. Autologous rates were 2.3%, 2.5%, 3.4%, and 2.6% for Medicare, Medicaid, privately insured, and uninsured patients, respectively. Medicare and Medicaid patients were more likely to receive allogeneic RBC than privately insured patients (Medicare: aOR: 1.42,

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“…Payer status is a key deciding factor in surgical care access, especially for complex and minimally invasive procedures. [ 16 17 18 ] Private and Medicaid patients were more likely to undergo GES placement, whereas Medicare patients underwent more pyloric intervention. Low socioeconomic gastroparesis patients are less likely to receive disease-specific intervention,[ 14 ] as there are only a few centres which perform GES placement, so people of lower socioeconomic status will not be able to afford to travel; nor will they have the proper insurance to cover their expenses for the surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of patients who underwent gastric electrical stimulation vs. surgical pyloric interventions for refractory gastroparesis

Saleem¹,

Hussain²,

Alsamman³

et al. 2021

Saudi J Gastroenterol

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Background: There has been recent debate comparing the efficacy of gastric electrical stimulation (GES) with pyloric intervention, but medical literature lacks clear indications for when to perform GES or pyloric intervention. This study aims to assess the effect of sociodemographic factors and hospital characteristics on the surgical technique chosen for the treatment of gastroparesis. Methods: Data was extracted from the National Inpatient Sample between the years 2012 and 2014, using any discharge diagnosis of gastroparesis. For comparison of analysis between GES and pyloric surgical intervention, pyloroplasty, endoscopic pyloric dilation, and pyloromyotomy were considered to be pyloric interventions. The study population was divided into two groups, one which received GES and the other receiving pyloric intervention, to compare socioeconomic factors and hospital characteristics. Results: In total, 737,930 hospitalizations had a discharge diagnosis of gastroparesis between 2012 and 2014. On weighted multivariant analysis of patients undergoing GES or pyloric intervention for gastroparesis, being female (odds ratio (OR) 1.49, 95% confidence interval (CI) 1.25–1.78; P < 0.001), being Hispanic (OR 1.75, 95%CI; P < 0.001), being in urban teaching (OR 1.41, 95%CI 1.15–1.72; P < 0.001), and nonteaching hospitals (OR 2.93, 95%CI 2.4–3.58; P < 0.001), early satiety (OR 6.70, 95%CI 1.54–31.25; P = 0.01), and diabetes mellitus (OR 2.14, 95%CI 1.78–2.56; P < 0.001) were each statistically significantly correlated with receiving GES intervention compared to pyloric intervention. Conclusion: The racial difference, payer source, and hospital location affected the surgical intervention (GES or pyloric intervention) that patients with gastroparesis would receive.

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Relationship between Patient Income Level and Mitral Valve Repair Utilization

Cited by 9 publications

References 20 publications

After Anterior Cruciate Ligament Injury, Patients With Medicaid Insurance Experience Delayed Care and Worse Clinical Outcomes Than Patients With Non-Medicaid Insurance

After Anterior Cruciate Ligament Injury, Patients With Medicaid Insurance Experience Delayed Care and Worse Clinical Outcomes Than Patients With Non-Medicaid Insurance

Medicare and Medicaid insurance status is associated with increased allogeneic red blood cell transfusion in cardiac surgery patients: 2007–2018

Characteristics of patients who underwent gastric electrical stimulation vs. surgical pyloric interventions for refractory gastroparesis

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