The following is a summary of “Association between social vulnerability index and admission urgency for transcatheter aortic valve replacement,” published in the March 2024 issue of Cardiology by Bolakale-Rufai et al.
Transcatheter aortic valve replacement (TAVR), a procedure to replace a heart valve, is not equally available to all. Good insurance might help narrow gaps among higher social vulnerability index (SVI) groups.
Researchers conducted a retrospective study to identify SVI’s association with commercial or Medicare insurance and how quickly people received TAVR receipts for aortic stenosis.
Investigators conducted a comprehensive retrospective study utilizing Optum’s de-identified Clinformatics Data Mart Database (CDM) to identify cases of TAVR procedures for aortic stenosis between (Jan 2018 – March 2022). They meticulously used CDM claims codes from these records to assess the urgency of patients’ admissions. Patients were cross-referenced and categorized into quintile groups based on their demographic locations and socioeconomic status. The study employed generalized linear mixed-effects models, adjusting for hospital-level covariates, to determine the urgency of the TAVR procedure in a patient.
The results showed 6,680 TAVR admissions with a median age of 80 years (IQR 75-85), with 43.9% females and 8.5% classified as urgent. Even after considering factors related to patients and hospitals, there were not any significant differences in how likely someone was to urgently be admitted for TAVR based on SVI quintiles [OR 5th (greatest social vulnerability) vs. 1st (least social vulnerability) 1.29 (95% CI: 0.90 – 1.85)].
Investigators concluded that SVI didn’t affect the urgency of TAVR admissions for aortic stenosis in commercial or Medicare beneficiaries. However, further research should explore the differences among Medicaid beneficiaries in terms of improved cardiovascular care delivery.
Source: sciencedirect.com/science/article/pii/S2666602224000132
