美国肺动脉高压患者在治疗模式、医疗资源使用和治疗效果方面的种族差异。

IF 2.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Current Medical Research and Opinion Pub Date : 2024-09-01 Epub Date: 2024-08-01 DOI:10.1080/03007995.2024.2377682
Lana Melendres-Groves, Wenze Tang, Hayley D Germack, Zhiwen Liu, Kay Sadik
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引用次数: 0

摘要

目的:这是一项使用索赔数据的回顾性研究:这项回顾性研究利用索赔数据比较了美国黑人和白人肺动脉高压(PAH)患者的人口统计学、临床特征、治疗模式、医疗资源利用率和临床结果:患者(年龄≥18 岁)有≥1 份 PAH 药物的药房报销单,连续加入医疗保险计划≥6 个月,在首次使用 PAH 药物前≤6 个月有≥1 份肺动脉高压诊断的住院/门诊医疗报销单,并有种族记录:这项分析包括 836 名黑人患者和 2896 名白人患者。与白人患者相比,黑人患者更年轻,受教育程度和家庭年收入水平更低,合并症评分更高。只有 14% 的黑人和白人患者接受了指标联合疗法。黑人患者对指数治疗的依从性较低。虽然对总体人群的调整回归分析表明各组间的治疗结果没有差异,但黑人患者的治疗结果却存在差异:黑人和白人 PAH 患者在人口统计学、临床特征和治疗模式方面存在差异。黑人与白人患者之间的差异
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Racial disparities in treatment patterns, healthcare resource use, and outcomes in patients with pulmonary arterial hypertension in the United States.

Objective: This retrospective study using claims data compared demographics, clinical characteristics, treatment patterns, healthcare resource utilization, and clinical outcomes in Black and White patients with pulmonary arterial hypertension (PAH) in the United States.

Methods: Patients (aged ≥18 years) had ≥1 pharmacy claim for PAH medication, ≥6 months' continuous healthcare plan enrollment, ≥1 inpatient/outpatient medical claim with a pulmonary hypertension diagnosis ≤6 months before first PAH medication, and race recorded.

Results: This analysis included 836 Black and 2896 White patients. Black patients were younger, with lower levels of education and annual household income, and higher comorbidity scores versus White patients. Only ∼14% of Black and White patients received index combination therapy. Lower adherence to index treatment was observed in Black patients. Although adjusted regression analysis in the overall population showed no differences in outcomes between groups, Black patients <65 years were 36% less likely to receive index combination therapy (odds ratio [OR] 0.64; 95% confidence interval [CI] 0.41-0.99), and 46% less likely to adhere to index treatment (OR 0.54; 95% CI 0.33-0.90). Other disparities included 24% higher all-cause health care resource utilization, 75% higher all-cause costs, and higher risk of clinical composite outcome. Social determinants of health (education, income, health insurance plan) partially mediated these race effects.

Conclusions: Differences in demographics, clinical characteristics, and treatment patterns between Black and White patients with PAH were observed. Disparities between Black and White patients <65 years were only partially mediated through social determinants of health variables, suggesting other factors may be involved.

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来源期刊
Current Medical Research and Opinion
Current Medical Research and Opinion 医学-医学:内科
CiteScore
4.40
自引率
4.30%
发文量
247
审稿时长
3-8 weeks
期刊介绍: Current Medical Research and Opinion is a MEDLINE-indexed, peer-reviewed, international journal for the rapid publication of original research on new and existing drugs and therapies, Phase II-IV studies, and post-marketing investigations. Equivalence, safety and efficacy/effectiveness studies are especially encouraged. Preclinical, Phase I, pharmacoeconomic, outcomes and quality of life studies may also be considered if there is clear clinical relevance
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