Abstract 18295: Racial and Insurance Disparities in Atrial Fibrillation Ablation
Objective: To identify possible racial and/or health insurance disparities with respect to ablation procedures for atrial fibrillation (AF).
Method: Using the Nationwide Inpatient Sample (2000-2011), we identified adult patients (pts) admitted with principle diagnosis of AF by ICD 9 code 427.31 who had catheter ablation (ICD 9 code - 37.34). We stratified patients by race (White, Black, Hispanic, and other minority racial groups), insurance status, age, gender, type of hospital, and type of hospital admission. A hierarchical mixed effect multivariate model was created to identify independent predictors of AF ablation.
Results: Among 4,547,144 patients hospitalized with AF during the study period, 201,447(4.43%) underwent ablation procedures. In absolute numbers, the majority of the ablations were performed in Whites (65.7%) and patients with Medicare (66.7%) or private insurance (24.7%). After adjusting for confounding factors, the proportions of Black pts (compare to White), and Medicare, Medicaid, and Uninsured pts (compare to private insurance), receiving ablation therapy were lower (see table). Odds of having ablation were lower in older and female patients and higher in teaching hospitals and after elective admissions (p<0.001 for all comparisions). Similar racial and insurance disparities were observed over the time course of the study.
Conclusion: We identified lower rates of AF ablation among black pts even after correction of other factors such as insurance. Ablation rates were also lower among patients without private insurance. These trends persisted during the study period of 2000-2011.
Author Disclosures: N.J. Patel: None. A. Deshmukh: None. A. Patel: None. N. Patel: None. B. Thakkar: None. S. Arora: None. N. Patel: None. V. Panchal: None. A.O. Badheka: None. M. Kowalski: None. H. Paydak: None. J.F. Viles Gonzalez: None. R.J. Myerburg: None. R.D. Mitrani: None.
- © 2014 by American Heart Association, Inc.