Policy, Payment & Practice -> Clinical Quality Measures and Outcomes D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-074 - Gender, Racial, And Socioeconomic Disparities In Ventricular Tachycardia Ablation (ID 75)

Disclosure
 R. Kipp: Nothing relevant to disclose.
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Abstract

Background: Limited information exists on the clinical and socioeconomic predictors of patients undergoing ventricular tachycardia (VT) ablation in the United States.
Objective: This retrospective analysis examined the clinical and socioeconomic predictors of patients who receive VT ablation.
Methods: In a national 100% U.S. Medicare inpatient dataset of fee-for-service beneficiaries admitted with VT or cardiac arrest from January 1, 2014 through November 30, 2014, multivariable logistic regression models were constructed to examine clinical and socioeconomic predictors associated with receiving ablation. Level of neighborhood socioeconomic disadvantage for each patient was measured by the Area Deprivation Index, a composite of education, income, housing, and employment factors.
Results: Of the 130,011 patients admitted with VT or cardiac arrest, 2193 (1.7%) received ablation. Those residing in the most disadvantaged neighborhoods had a lower rate of ablation (Figure 1). After adjustment for age, gender, race, hospital characteristics, socioeconomic characteristics, occurrence of cardiac arrest, and medical comorbidities, female gender (OR 0.78, 95% CI 0.69-0.87), African American race (OR 0.75, 95% CI 0.63-0.89), and living in a disadvantaged neighborhood (OR 0.83, 95% CI 0.70-0.98) were associated with lower odds of ablation.
Conclusion: Women, African Americans and patients living in less affluent neighborhoods were significantly less likely to undergo ablation following hospitalization for VT or cardiac arrest even after controlling for comorbidities. The etiology of and solutions to these disparities requires further investigation.
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