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心血管疾病患者医疗支出与资源利用中的种族和族裔差异

Racial and Ethnic Disparity in Healthcare Expenditure and Resource Utilization Among Patients with Cardiovascular Diseases.

作者信息

Zakeri Marjan, Lal Lincy S, Abughosh Susan M, Sansgiry Shubhada, Essien Ekere James, Sansgiry Sujit S

机构信息

Pharmaceutical Health Outcomes and Policy Department, College of Pharmacy, University of Houston, Texas Health Building 2, 4849 Calhoun Road, Room 4050, Houston, TX, 77204-5047, USA.

Adjunct Faculty, Department of Management, Policy Community Health, The University of Texas School of Public Health, Houston, TX, USA.

出版信息

J Racial Ethn Health Disparities. 2024 Aug 14. doi: 10.1007/s40615-024-02125-7.

Abstract

BACKGROUND

Despite extensive research, significant gaps remain in understanding racial disparity among individuals with cardiovascular diseases (CVD). These disparities, influenced by factors such as access to care and comorbid conditions, necessitate further investigation to develop targeted interventions.

AIM

To evaluate the factors contributing to racial and ethnic disparities in healthcare resource utilization and total healthcare expenditure among individuals with CVD.

METHODS

Using data from the Medical Expenditure Panel Survey spanning 2014-2021, total healthcare expenditure and having a CVD visit were compared among Hispanic, Black, and White adults with CVD. Descriptive analysis, linear regression, and logistic regression models were used to compare the results. Multivariable models were used to evaluate the effect of demographic and socioeconomic factors on total healthcare expenditure and the likelihood of having a CVD visit among different races.

RESULTS

With a weighted sample of 17,722,706, the study found that Hispanic and Black cohorts had 23% and 11% lower healthcare expenditures (both p < 0.001). Hispanic and Black cohorts also had lower odds of having a CVD visit (odds ratio [OR] = 0.61, 95% confidence interval [CI]:0.55-0.68; OR = 0.58, 95% CI: 0.52-0.65, respectively) compared to the White cohort. Key predictors included physical and cognitive limitations, insurance status, income, region, and the year of data collection.

CONCLUSION

This study highlights the need for targeted interventions to address healthcare disparities and promote health equity among minority populations with CVD.

摘要

背景

尽管进行了广泛研究,但在理解心血管疾病(CVD)患者的种族差异方面仍存在重大差距。这些差异受获得医疗服务的机会和合并症等因素影响,需要进一步调查以制定有针对性的干预措施。

目的

评估导致CVD患者在医疗资源利用和总医疗支出方面存在种族和民族差异的因素。

方法

利用2014 - 2021年医疗支出面板调查的数据,比较了患有CVD的西班牙裔、黑人和白人成年人的总医疗支出以及进行CVD就诊的情况。使用描述性分析、线性回归和逻辑回归模型来比较结果。多变量模型用于评估人口统计学和社会经济因素对不同种族总医疗支出和进行CVD就诊可能性的影响。

结果

在加权样本为17,722,706的情况下,研究发现西班牙裔和黑人队列的医疗支出分别低23%和11%(均p < 0.001)。与白人队列相比,西班牙裔和黑人队列进行CVD就诊的几率也较低(优势比[OR]分别为0.61,95%置信区间[CI]:0.55 - 0.68;OR = 0.58,95% CI:0.52 - 0.65)。关键预测因素包括身体和认知限制、保险状况、收入、地区以及数据收集年份。

结论

本研究强调需要采取有针对性的干预措施,以解决医疗差距问题,并促进患有CVD的少数族裔人群的健康公平。

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