title: Sex, Race, and Socioeconomic Disparities in Patients With Aortic Stenosis (from a Nationwide Inpatient Sample).
abstract: Aortic stenosis (AS) is the third most prevalent cardiovascular disease following hypertension and coronary artery disease. The primary objective of this cross-sectional study is to examine gender, racial, and socioeconomic disparities in AS-related health care utilization in patients aged ≥50 years using data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample. AS was identified among inpatient discharges with International Classification of Diseases, Ninth Revision, Clinical Modification, code 424.1. Using stratum-specific weighted totals, means, proportions, and regression models, we examined time trends and disparities for inhospital AS prevalence according to gender, race, and income over the 2002 to 2012 period, predictors of AS (gender, race, income, age, health insurance, co-morbidities, and hospital-level characteristics), and AS's role as a predictor of inhospital death, length of stay, and total charges. Inhospital AS prevalence increased from 2.10% in 2002 to 2.37% in 2012, with similar trends observed within gender, race, and income strata. Women were less likely to have AS compared with men (adjusted odds ratio [ORadj] 0.84; 95% confidence interval [CI] 0.83 to 0.86). Blacks (ORadj 0.68; 95% CI 0.66 to 0.71), Hispanics (ORadj 0.79; 95% CI 0.76 to 0.84), and Asians/Pacific Islanders (ORadj 0.68; 95% CI 0.64 to 0.74) were less likely than whites to have AS diagnosis that was directly associated with income. AS was inversely related to inhospital death but positively linked to total charges overall and longer hospital stays among men, whites, and middle-income patients. However, shorter stays with AS were observed among blacks. In conclusion, among older inpatients, AS prevalence was ∼2% and was higher among males, whites, and higher income groups. Although inhospital death was lower and total charges were higher in AS, length of stay's association with AS varied by gender, race, and income.
authors.affiliation: Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, Virginia; Department of Hospital Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: hindb1972@gmail.com.
authors.forename: Hind A
authors.initials: HA
authors.lastname: Beydoun
authors.affiliation: Laboratory of Epidemiology and Population Science, National Institute on Aging Intramural Research Program, Baltimore, Maryland.
authors.forename: May A
authors.initials: MA
authors.lastname: Beydoun
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Hailun
authors.initials: H
authors.lastname: Liang
authors.affiliation: Laboratory of Epidemiology and Population Science, National Institute on Aging Intramural Research Program, Baltimore, Maryland.
authors.forename: Greg A
authors.initials: GA
authors.lastname: Dore
authors.affiliation: Department of Psychology, University of Maryland, Baltimore County, Baltimore, Maryland.
authors.forename: Danielle
authors.initials: D
authors.lastname: Shaked
authors.affiliation: Laboratory of Epidemiology and Population Science, National Institute on Aging Intramural Research Program, Baltimore, Maryland.
authors.forename: Alan B
authors.initials: AB
authors.lastname: Zonderman
authors.affiliation: Department of Hospital Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Shaker M
authors.initials: SM
authors.lastname: Eid
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D001024:Aortic Valve Stenosis / Q000453:epidemiology* / Q000208:ethnology; D001213:Asian / Q000706:statistics & numerical data; D016208:Databases, Factual; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D017722:Hospital Charges / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data; D016017:Odds Ratio; D015995:Prevalence; D012737:Sex Factors; D012923:Social Class; D014481:United States; D044465:White People / Q000706:statistics & numerical data