Abstract
ImportanceChicago is one of the most racially segregated cities in the US, with the largest mortality gap between neighborhoods. Computed tomographic coronary artery calcium scoring (CACS) is an excellent risk stratification tool, but costs about $200 out-of-pocket, making it inaccessible to some. ObjectiveTo determine whether this ACC/AHA guideline-recommended screening tool is accessible to all populations and neighborhoods, we evaluated the price and availability of CACS in Chicago area hospitals. DesignWe used the Illinois Department of Public Health list of area hospitals to inquire about CACS availability and price. We compared these results to US Census Bureau data for each hospital's service area's demographic, ethnic and socioeconomic population characteristics. ResultsOut of the 40 hospitals in Chicagoland, 30 offered CACS. The 10 hospitals without CACS were smaller hospitals in zip codes with a higher population density (p < 0.01), higher poverty rates (22% vs. 13%, p < 0.01), lower percentage of white population (p < 0.02), lower frequency of higher education (35% vs. 51%, p < 0.05), and a trend toward more black residents (p < 0.10). Life expectancy was greater in areas with CACS available (78 vs. 75 years, p < 0.05).Even in areas with CACS, there was wide price variation, with higher prices in poorer areas (r = 0.57, p < 0.01). The highest vs. lowest quintile of income had higher education, larger white population (80% vs. 14%, p < 0.0001), and longer life expectancy (81 vs. 72 years, p < 0.0002), but tended to have a lower price of CACS ($86 vs. $487, p < 0.08). Conclusions and relevanceCACS is a powerful, evidenced-based clinical tool, but the availability and price vary widely in Chicagoland, and directly correlate with the socioeconomic and health care disparities that are known to exist. Removing these barriers to coronary artery disease screening may be one method to improve the poor cardiovascular outcomes in these areas.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
