Valvular & structural heart disease
Economic Disparities in Utilization and Outcomes of Structural Heart Disease Interventions in the United States
Authors' conclusion
Economic disparities exist in the utilization of SHD interventions in the United States. Nonetheless, adjusted in-hospital outcomes were comparable among high-, medium-, and low-income patients.
Study context
- Population
- Patients ≥65 years undergoing structural heart disease (SHD) interventions (TAVR, LAAO, transcatheter mitral valve repair or replacement), US
- Participants
- 401,005 weighted hospitalizations
- Exposure
- High vs medium vs low income
- Outcome
- Utilization of SHD interventions (procedures per 100,000 hospitalizations)
Methodological detailsNational Inpatient Sample (2016-2020)
- National Inpatient Sample (2016-2020)
Main finding
As reported in the abstract
Utilization rate (procedures per 100,000 hospitalizations)
| Group | TAVR | LAAO | Transcatheter mitral valve repair | Transcatheter mitral valve replacement |
|---|---|---|---|---|
| High income | 559 | 148 | 65 | 7.7 |
| Medium income | 456 | 136 | 54 | 6.7 |
| Low income | 338 | 99 | 41 | 1.2 |
TAVR
High income559
Medium income456
Low income338
LAAO
High income148
Medium income136
Low income99
Transcatheter mitral valve repair
High income65
Medium income54
Low income41
Transcatheter mitral valve replacement
High income7.7
Medium income6.7
Low income1.2
- Utilization higher with high income vs medium and low income for all 4 procedures
- all P < 0.01
Observational data: associations, not effects.
Further findings
Adjusted in-hospital mortality, key complications, length of stay
- No significant differences between high-, medium- and low-income patients after any of the 4 SHD interventions
Cost
- Modestly higher cost in high-income vs medium- and low-income patients with any of the 4 SHD interventions
Original publication
Economic Disparities in Utilization and Outcomes of Structural Heart Disease Interventions in the United States. JACC Adv. Published 3 July 2024. doi:10.
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