Hispanic PAD patients often face longer hospitalizations, higher costs

Many Hispanics adult patients with peripheral artery disease (PAD) seek treatment through the emergency department (ED) instead of a primary care provider, according to new data to be presented at the American Health Association’s Quality of Care and Outcomes Research (QCOR) Scientific Sessions 2021. This patient population also faces a higher risk of long hospitalizations and high healthcare costs. 

Harris et al. analyzed hospital admissions data from the 2011-2017 National Inpatient Sample to evaluate differences in the experiences of Hispanic and non-Hispanic white adults who sought treatment for PAD symptoms.

The authors found that there were 1,018,220 PAD hospitalizations among adults patients. Thirty-nine percent of patients were women, and 14% were Hispanic. Hispanic adults with PAD were 80% more likely to be admitted to the hospital through the ED than non-Hispanic white patients. They also had longer average hospital stays (4.5 days vs. 3.7 days) and higher average hospital costs ($63,813 vs. $52,368). 

Between 2011 and 2017, the proportion of patients who sought inpatient hospital care through the ED rose among both Hispanic adults and non-Hispanic white adults. The rise was especially noteworthy, however, among Hispanics patients. Overall, the percentage of PAD hospital admissions occurring through the ED climbed from 50% to 70%.

Also, Hispanic adults were 12% less inclined to pursue elective hospital admissions for PAD.

Researchers pointed out that for certain Hispanic adults, the ED may be a better way to gain access to healthcare, particularly if they don’t have health insurance or have questionable immigration status.

“The Hispanic population is one of the fastest growing ethnic groups in the U.S., and prior studies have shown worse outcomes among Hispanic adults with PAD, including higher rates of amputation and fewer revascularization procedures compared to non-Hispanic white adults with PAD,” lead author Kristie Harris, PhD, an instructor of medicine at Yale School of Medicine, said in a press release. “The prevalence of PAD among Hispanic individuals has been difficult to determine because this population often experiences a lack of access to health care and is underrepresented in many population-based studies. Our study raises awareness and confirms some of these disparities.”

Harris added that her team's work confirms a finding that previous studies had also reached: "Hispanic individuals often lack a usual source for routing healthcare and frequently defer or avoid care due to costs." 

“Instead of delaying care, a better way to manage PAD and reduce the risks of future complications is with regular evaluation and follow-up, usually with a primary care doctor or vascular specialist," she said. 

Th study's authors also highlighted the importance of developing better PAD prevention and management programs in the Hispanic community, which might lead to a reduction in ED use or hospitalizations.

“Systematic efforts are needed to ensure Hispanic people with PAD have more accessible, affordable and culturally sensitive outpatient care," Harris said. "Efforts should include supports that educate the community regarding the signs and symptoms of PAD and encouragement to seek care early."

The QCOR Scientific Sessions 2021 will be held virtually on Monday, Nov. 15. More information is available here

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