Disparities in access to left ventricular assist device therapy

Area of Science:

• Cardiology
• Health Services Research
• Medical Technology Access

Background:

• Left ventricular assist device (LVAD) implantation improves survival and quality of life in end-stage heart failure patients.
• The complex and costly nature of LVAD therapy suggests potential influences from healthcare access disparities.

Purpose of the Study:

• To investigate the impact of patient and hospital characteristics on LVAD implantation rates.
• To identify disparities in access to LVAD therapy.

Main Methods:

• Analysis of National Inpatient Sample data from 2002-2003.
• Inclusion criteria: patients with congestive heart failure or cardiogenic shock, excluding those over 85 or with contraindications.
• Multivariate logistic regression assessed factors influencing LVAD implantation.

Main Results:

• Out of 297,866 eligible patients, only 291 received LVAD implantation.
• Factors negatively associated with LVAD access included older age (>65), female gender, Black race, non-academic hospital admission, and geographic region.

Conclusions:

• LVAD implantation rates are significantly affected by healthcare access disparities.
• Systematic reforms are necessary to ensure equitable delivery of advanced medical technologies like LVADs.