Abstract 217: Racial Disparities in Echocardiography Use Within The Veterans Administration and Medicare Systems

Autor: Sheeva Rajaei, Peter Groeneveld, John Teerlink, Mary Whooley, Mintu Turakhia, Ilana Richman, Anju Sahay, Vinay Kini, Paul A Heidenreich
Rok vydání: 2015
Předmět:
Zdroj: Circulation: Cardiovascular Quality and Outcomes. 8
ISSN: 1941-7705
1941-7713
DOI: 10.1161/circoutcomes.8.suppl_2.217
Popis: Background: There is increasing interest in understanding the factors that influence the use of diagnostic imaging in heart failure in US health systems. However, there is limited data examining overall use and the impact of racial disparities in the VA and Medicare. Methods: We analyzed Veterans Healthcare Administration (VA) and Medicare data from 2002 to 2009 to identify veteran patients above the age of sixty-five with a diagnosis of heart failure for at least 1 year. Patients receiving care in both systems were excluded. We examined patients undergoing echocardiography and scintigraphy each year by race and system of care. Multivariate logistic regression analyses were performed adjusting for age, gender and comorbidities. Results: A total of 2,917,307 veteran patients were included (263,778 in VA and 1,698,497 in Medicare). Overall use of echocardiography each year was 45.6% for Whites, 51.9% for Asians, 43.2% for Blacks, 39.7% for Hispanics, 42.0% for Pacific Islanders, 40.9% for Native-American and 48.1% for Other. The adjusted odds ratio of undergoing echocardiography was higher for Asians in both systems compared to Whites (Figure). In Medicare, use was lower for Native Americans, Blacks and Hispanics compared to Whites. In the VA, use among Blacks and Hispanics was higher than Whites. Conclusion: There are significant differences in echocardiography use between the VA and Medicare systems by race for veterans with heart failure. Whites were more likely to receive echocardiography compared to most races in Medicare but not in the VA.
Databáze: OpenAIRE
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