Abstract 11682: Race, Sex, and Socioeconomic Disparities in Hospitalization With Ventricular Tachycardia or Cardiac Arrest in a National Medicare Cohort

Abstract

Introduction: Significant disparities by race, sex, and socioeconomic status exist in cardiovascular care. Yet little is known regarding the disparities in patients hospitalized with life-threatening arrhythmias. Hypothesis: We hypothesize that there are differences in race, sex, and socioeconomic status between patients who develop ventricular tachycardia (VT) or cardiac arrest (CA). Methods: Using the national 100% U.S. Medicare inpatient dataset of fee-for-service beneficiaries admitted with VT or CA from January 1, 2014 through November 30, 2014, multivariable logistic regression was constructed to examine the characteristics associated with hospitalization with VT compared to those with CA. Neighborhood-level socioeconomic disadvantage for each patient was measured by the Area Deprivation Index which reflects 17 dimensions related to education, income, housing, and employment factors. Results: Of 195,806 patients admitted with VT or CA, 117,930 (60%) were admitted with VT and 77,876 (40%) with CA. Those residing in the most disadvantaged neighborhoods had a significantly lower rate of hospitalization with VT, and a higher rate of hospitalization with CA (Figure 1). After adjustment for baseline demographics, comorbidities, and hospital characteristics, living in one of the top 20% most disadvantaged US neighborhoods (OR 1.09, 95% CI 1.05-1.12), female sex (OR 1.27, 95% CI 1.24-1.29), non-White race (OR 1.16, 95% CI 1.12-1.20), and non-urban residence (OR 1.10, 95% CI 1.06-1.14) were associated with greater odds of hospitalization with CA. Conclusion: Significant differences exist in the race, sex, and neighborhood socioeconomic characteristics for patients hospitalized with VT compared to those with CA. Possible etiologies for these differences include geographic or economic barriers in accessing acute medical care or trust in the medical system. Further studies are needed to investigate the drivers and solutions to this difference.