Disparities in healthcare utilization by insurance status among patients with symptomatic peripheral artery disease.
BMC Health Serv Res
; 23(1): 913, 2023 Aug 28.
Article
em En
| MEDLINE
| ID: mdl-37641048
ABSTRACT
BACKGROUND:
Peripheral artery disease (PAD) is a common circulatory disorder associated with increased hospitalizations and significant health care-related expenditures. Among patients with PAD, insurance status is an important determinant of health care utilization, treatment of disease, and treatment outcomes. However, little is known about PAD-costs differences across different insurance providers. In this study we examined possible disparities in length of stay and total charge of inpatient hospitalizations among patients with PAD by insurance type.METHODS:
We conducted a cross-sectional analysis of length of stay and total charge by insurance provider for all hospitalizations for individuals with PAD in South Carolina (2010-2018). Cross-classified multilevel modeling was applied to account for the non-nested hierarchical structure of the data, with county and hospital included as random effects. Analyses were adjusted for patient age, race/ethnicity, county, year of admission, admission type, all-patient refined diagnostic groups, and Charlson comorbidity index.RESULTS:
Among 385,018 hospitalizations for individuals with PAD in South Carolina, the median length of stay was 4 days (IQR 5) and the median total charge of hospitalization was $43,232 (IQR $52,405). Length of stay and total charge varied significantly by insurance provider. Medicare patients had increased length of stay (IRR = 1.08, 95 CI% 1.07, 1.09) and higher total charges (ß 0.012, 95% CI 0.007, 0.178) than patients with private insurance. Medicaid patients also had increased length of stay (IRR = 1.26, 95% CI 1.24,1.28) but had lower total charges (ß -0.022, 95% CI -0.003. -0.015) than patients with private insurance.CONCLUSIONS:
Insurance status was associated with inpatient length of stay and total charges in patients with PAD. It is essential that Medicare and Medicaid individuals with PAD receive proper management and care of their PAD, particularly in the primary care settings, to prevent hospitalizations and reduce the excess burden on these patients.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
11_ODS3_cobertura_universal
/
1_ASSA2030
Problema de saúde:
11_delivery_arrangements
/
11_governance_arrangements
/
1_acesso_equitativo_servicos
Assunto principal:
Medicare
/
Doença Arterial Periférica
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Aspecto:
Implementation_research
Limite:
Aged
/
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
BMC Health Serv Res
Assunto da revista:
PESQUISA EM SERVICOS DE SAUDE
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos