Abstract 14389: Mitigating Health Disparities by Improving Access to Advanced Multidisciplinary Care for Vulnerable Patients With Intermediate and High-Risk Pulmonary Embolism

Abstract

Background: Vulnerable patients, including minorities and underserved populations whose care rely on public hospitals, have limited access to advanced pulmonary embolism (PE) treatment, particularly when catheter-based therapies (CBT) and escalation of care are needed. Our aim is to describe the multidisciplinary pulmonary embolism response team (PERT) program for the largest public health system in the country, as a strategy to mitigate healthcare disparities and improve access to care. Methods: We collected clinical, demographic and socioeconomic data from patients with intermediate-high and high-risk PE undergoing CBT at Bellevue Hospital, a PERT referral center and level 1 shock center for New York City’s Health and Hospitals’ network. Outcomes included in-hospital mortality and complications from CBT. Results: Sixty-one patients were included (42.6% women, age 57 ± 13.7 years) between October, 2022 to April 2023; 80.3% had intermediate-risk PE, 19.7%% had high-risk PE. The majority were black (57.4%), followed by Hispanic (13%). A total of 13% were uninsured, 9.8% were undocumented and 50.8% lived below the poverty level for New York City. The level of education was 8th grade or less in 4.9% of patients, high school in 29.5%, at least 2 years of college in 6.6%, >4 years of college in 8.2%, master’s degree in 4.9% and unknown in 46%. Disease severity markers (CPES, PESI, BOVA, lactate, troponin and BNP) did not vary by ethnic group. There were no differences in mortality between white and non-white patients (figure); 3(4.9%) patients required rescue extracorporeal support and there were no procedural related complications. Conclusions: Our multidisciplinary PERT program demonstrates feasibility to provide care to underserved and vulnerable populations with excellent outcomes, serving as a strategy to help decrease healthcare disparities, particularly for advanced therapies for a challenging condition such as intermediate and high-risk PE.