The impact of socioeconomic factors on outcome and hospital costs associated with femoropopliteal revascularization

Durham, Christopher A.; Mohr, Margaret C.; Parker, Frank M.; Bogey, William M.; Powell, Charles S.; Stoner, Michael C.

doi:10.1016/j.jvs.2010.04.011

Cited by 35 publications

(29 citation statements)

References 27 publications

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“…Income above 100 percent of the federal poverty line was protective against limb loss in a small study of femoropopliteal revascularization patients (AOR 0.06, 95% CI 0.01–0.51, p<0.001). 51 Guagliardo et al found that SES was a significant predictor of appendiceal perforation (AP) for California pediatric patients, but not for New Yorkers. 52 While this area will certainly benefit from further study, Lee et al note that this potential inequality may be the manifestation of an access barrier.…”

Section: Methodsmentioning

confidence: 99%

Racial Disparities in Surgical Care and Outcomes in the United States: A Comprehensive Review of Patient, Provider, and Systemic Factors

Haider

Scott

Rehman

et al. 2013

Journal of the American College of Surgeons

466

262

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Summary It is well known that there are significant racial disparities in health care outcomes, including surgery. However, the mechanisms that lead to these disparities are still not fully understood. In this comprehensive review of the currently published surgical disparity literature in the United States, we assess racial disparities in outcomes after surgical procedures, focusing on patient, provider, and systemic factors. The PubMed, EMBASE, and Cochrane Library electronic databases were searched with the keywords: healthcare disparities AND surgery AND outcome AND US. Only primary research articles published between April 1990 and December 2011 were included in the study. Studies analyzing surgical patients of all ages and assessing the endpoints of mortality, morbidity, or the likelihood of receiving surgical therapy were included. A total of 88 articles met the inclusion criteria. This evidence-based review was compiled in a systematic manner, relying on retrospective, cross-sectional, case-control, and prospective studies in the absence of Class I studies. The review found that patient factors such as insurance status and socioeconomic status (SES) need to be further explored, as studies indicated only a premature understanding of the relationship between racial disparities and SES. Provider factors such as differences in surgery rates and treatment by low volume or low quality surgeons also appear to play a role in minority outcome disparities. Finally, systemic factors such as access to care, hospital volume, and hospital patient population have been shown to contribute to disparities, with research consistently demonstrating that equal access to care mitigates outcome disparities.

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Section: Methodsmentioning

confidence: 99%

Racial Disparities in Surgical Care and Outcomes in the United States: A Comprehensive Review of Patient, Provider, and Systemic Factors

Haider

Scott

Rehman

et al. 2013

Journal of the American College of Surgeons

466

262

View full text Add to dashboard Cite

show abstract

“…31 Socioeconomic, gender, and racial factors strongly influence procedural safety and efficacy measures. [32][33][34] Categorization of these factors is possible using simple scoring systems for highest level of education and household income stratified by multiples of the federal poverty line. Full characterization of these factors will likely be outside of the scope of most device and modality-centric endovascular studies but is something for authors to consider, especially in large-scale longitudinal outcome studies.…”

Section: Patient Factorsmentioning

confidence: 99%

Reporting standards of the Society for Vascular Surgery for endovascular treatment of chronic lower extremity peripheral artery disease

Stoner

Calligaro

Chaer

et al. 2016

Journal of Vascular Surgery

Self Cite

345

264

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Peripheral arterial disease (PAD) represents a spectrum from asymptomatic stenosis to limb-threatening ischemia. The last decade has seen a tremendous increase in the variety of endovascular devices and techniques to treat occlusive disease. Like many evolving technologies, the literature surrounding therapy for endovascular arterial disease consists of mixed-quality manuscripts without clear standardization. Accordingly, critical evaluation of the reported results may be problematic. As such, providers and their patients make treatment decisions without the full benefit of a comparative effectiveness framework. The purpose of this document is to provide a summary for the reporting of endovascular revascularization techniques in the setting of chronic disease. Much of the work in this document is based on prior publications and standards proposed by the Society for Vascular Surgery. We have also made recommendations based on current literature and have attempted to acknowledge shortcomings and areas for future research. The various sections contain summaries of required reporting standards and should serve as a guide for the design of clinical trials and as reference for journal editors and reviewers when considering scientific work pertaining to endovascular therapy for chronic lower extremity arterial disease. An Appendix is provided with commonly used abbreviations in this document.

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“…12 Additionally, patients with lower socioeconomic status based on median household income levels had an increased risk for readmission, likely due to lack of access to healthcare or receiving care at poor-quality hospitals. 13 …”

Section: Understanding Readmission Following Vascular Surgery: a Concmentioning

confidence: 99%

Developing strategies for predicting and preventing readmissions in vascular surgery

Brooke

Martino

Girotti

et al. 2012

Journal of Vascular Surgery

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The escalating cost burden of hospital readmission has prompted recent nationwide efforts aimed at reducing the incidence of this important quality measure. Because patients undergoing vascular surgery account for a significant proportion of readmissions, vascular surgeons may face reduced reimbursements in the near future if these trends continue. However, risk factors associated with readmission remain poorly defined, and further research is needed to identify interventions that will prevent readmission following vascular procedures. Accordingly, this manuscript will (1) propose a conceptual model to explain the driving forces behind readmissions in vascular surgery, (2) review current evidence directed at identifying risk factors and evaluating interventions to reduce readmissions across different medical and surgical specialties, and (3) identify key areas in patient care where targeted research or interventions may be implemented in vascular surgery.

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The impact of socioeconomic factors on outcome and hospital costs associated with femoropopliteal revascularization

Abstract: Income level correlates with advanced presentation, advanced age, and lack of statin use. Although primary assisted patency rate is not affected by income status, an increased cost-per-day of patency and inferior limb salvage is found in lower income patients.

Cited by 35 publications

References 27 publications

Racial Disparities in Surgical Care and Outcomes in the United States: A Comprehensive Review of Patient, Provider, and Systemic Factors

Racial Disparities in Surgical Care and Outcomes in the United States: A Comprehensive Review of Patient, Provider, and Systemic Factors

Reporting standards of the Society for Vascular Surgery for endovascular treatment of chronic lower extremity peripheral artery disease

Developing strategies for predicting and preventing readmissions in vascular surgery

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