Lowest-income patients less likely to use CVD prevention services
Click Here to Manage Email Alerts
Poorer adults were less likely to be screened for typical CVD risk factors or receive counseling for prevention than patients with higher incomes, regardless of their CV status, researchers reported.
In a presentation at the virtual American Heart Association Quality of Care and Outcomes Research Scientific Sessions, investigators reported that regardless of CVD status, individuals with very low incomes were less likely to have the following than participants with high incomes:
- a cholesterol check within the previous 5 years (OR in patients without CVD = 0.36; 95% CI, 0.33-0.38; OR in patients with CVD = 0.33; 95% CI, 0.26-0.42);
- counseling on healthy diet (OR without CVD = 0.77; 95% CI, 0.74-0.81; OR with CVD = 0.95; 95% CI, 0.86-1.04);
- advice on exercising more (OR without CVD = 0.81; 95% CI, 0.77-0.85; OR with CVD = 0.84; 95% CI, 0.76-0.93);
- BP measurement within the previous 2 years (OR without CVD = 0.41; 95% CI, 0.37-0.45; OR with CVD = 0.32; 95% CI, 0.22-0.46); and
- advice to quit smoking for current smokers (OR without CVD = 0.71; 95% CI, 0.63-0.79; OR with CVD = 0.78; 95% CI, 0.61-0.99).
“In our study, we learned that people of lower income are less likely to receive basic screening or counseling to help reduce their risk of developing new or worsening CVD,” Andi Shahu, MD, MHS, internal medicine resident physician at The Johns Hopkins Hospital, told Healio. “The results were similar regardless of whether people had had CVD in the past. The findings are important for cardiac clinicians to know so that they can be aware of the disparities that different patient populations may experience and provide greater support in their clinical practice for socioeconomically disadvantaged patients to receive necessary screening to prevent CVD.”
Using data from the Medical Expenditure Panel Survey, which collected participant data via telephone survey and care utilization via physicians, hospitals and pharmacies, researchers categorized participants with and without CVD as high income (400% of federal poverty level), middle income (200% to 400% of federal poverty level), low income (125% to 200% of federal poverty level) and very low income (< 125% of federal poverty level).
“More work needs to be done to better understand the likely complex mechanisms by which these disparities occur today,” Shahu said in an interview. “However, these kinds of problems cannot be fixed at the bedside alone. They are the result of systemic inequity that perpetuates to this day in our health care system, an issue that must be addressed through major policy change at the national, state and local level.” – by Scott Buzby
Reference:
Shahu A, et al. Presentation 385. Presented at: American Heart Association Quality of Care and Outcomes Research Scientific Sessions; May 15-16, 2020 (virtual).
Disclosures: The authors report no relevant financial disclosures.
Collapse
Read more about
Click Here to Manage Email Alerts