ACC.14: Race influences downstream costs following stress echo

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WASHINGTON, D.C.—Despite access to care, a study of Medicare beneficiaries who underwent stress echocardiography found race significantly impacts downstream two-year cardiac costs, with non-white patients having significantly lower costs, according to a poster presentation at the American College of Cardiology (ACC) scientific session.

The reduced costs were in spite of higher clinical and socioeconomic risk factors in the non-white patient population in the study, according to Patrick Collier, MD, PhD, and colleagues from the Cleveland Clinic.

The authors included 3,791 Medicare patients who underwent stress echo at Cleveland Clinic from 2002 through 2008. Initial indications for the test included symptom evaluation, ruled out coronary artery disease, follow-up on coronary artery disease, assessed valve function or preoperative exam. Medicare claim files were used to determine the downstream costs.

Results showed that cardiac charges were 31 percent less for non-white patients compared with white patients, with average charges of $5,656 and $8,159, respectively.

“Although the breakdown of test results was not different between groups, non-white patients had a significantly higher rate of smoking, diabetes, renal dysfunction, hypertension and adverse socioeconomic indicators,” wrote the authors.

They added that after adjusting for known risk factors, there was no difference in death rate by race.