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Prevalence of cardiovascular conditions and health services utilization in Puerto Rico, 2001
Mario R García-Palmieri1, Rosa Pérez-Perdomo, Samira Rosa Colón
1School of Medicine and Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico. mgarcia@rcm.upr.edu
Insights
Cardiovascular disease prevalence and healthcare use in Puerto Rico differed significantly between private and public sectors in 2001. The private sector showed higher prevalence, particularly hypertension, while males utilized services more, though sector variations were noted.
Area of Science:
- Cardiovascular epidemiology
- Health services research
- Public health
Background:
- Cardiovascular diseases (CVDs) represent a significant public health burden globally and in Puerto Rico.
- Understanding the prevalence and healthcare utilization patterns is crucial for targeted interventions.
- Previous studies have not fully elucidated sector-specific differences in CVDs within Puerto Rico.
Purpose of the Study:
- To determine the prevalence of major cardiovascular conditions in Puerto Rico during 2001.
- To analyze health services utilization patterns related to cardiovascular conditions across different sectors.
- To identify disparities in cardiovascular health and service use between private and public sectors.
Main Methods:
- Retrospective analysis of medical claims data from private and public insurance sectors in Puerto Rico for the year 2001.
- Inclusion criteria focused on specific ICD-9 codes for coronary heart disease, hypertension, congestive heart failure, and cerebrovascular accidents.
- Prevalence and healthcare utilization metrics (physician visits, ER visits, hospital admissions) were calculated with 95% confidence intervals.
Main Results:
- Overall cardiovascular condition prevalence was 13.5%, higher in the private sector (16.0%) than the public sector (11.7%).
- Hypertension was the most common condition (9.7%), with higher prevalence in females.
- Males exhibited higher health service utilization, but patterns varied by sector; prevalence increased with age in both sectors, being double in the private sector at similar ages.
Conclusions:
- Significant disparities exist in cardiovascular condition prevalence and healthcare service utilization between private and public sectors in Puerto Rico.
- Factors such as socioeconomic status, education, lifestyle, and environmental influences likely contribute to these observed differences.
- Targeted public health strategies are needed to address the inequities in cardiovascular health outcomes and service access.
Abstract:
OBJECTIVE To study the prevalence of cardiovascular conditions and health services utilization in Puerto Rico, 2001. METHODS All medical claims for coronary heart disease (ICD-9 410-414), hypertension (ICD-9 401-405), congestive heart failure (ICD-9 428) and cerebrovascular accidents and transient ischemia (ICD-9:430-438.9) submitted for reimbursement purposes to an insurance company (private and public sector) in Puerto Rico in 2001 were identified. Prevalence and medical care utilization concerning cardiovascular conditions was estimated with 95% confidence. RESULTS Overall prevalence of cardiovascular conditions was 13.5% (95% CI: 11.68%-15.44%), being larger in the private sector (16.0%; 95% CI: 15.98%-16.08% vs. 11.7%; 95% CI: 11.62%-11.77%). Although in both sectors prevalence increased with age, at same age groups was two times higher in the private sector. Hypertension was the most prevalent condition (9.7; 95% CI: 8.14%-11.41%) being higher in females (10.4; 95% CI: 10.37%-10.51%) than in males (8.9; 95% CI: 8.81%-8.96%). The health service utilization (physician's office visits, emergency room visits, and hospital admissions) was higher in males. However, it varies by sectors. CONCLUSIONS Significant difference exists in the prevalence of cardiovascular conditions and health services utilization among private and public sectors in Puerto Rico. The observed differences among the private and public populations imply that there are factors such as socioeconomic status, education, lifestyles, environmental hazards in neighborhoods, and health habits that could be involved in the differences.
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