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Racial Disparities in PAD-Related Amputation Rates among Native Americans and non-Hispanic Whites: An HCUP Analysis
Insights
Native Americans with peripheral artery disease (PAD) in the West Census Region face higher amputation rates. This disparity persists even after accounting for various health and demographic factors, highlighting regional inequities.
Area of Science:
- Health Disparities
- Vascular Surgery
- Public Health
Background:
- Peripheral artery disease (PAD) affects numerous populations globally.
- Amputation rates due to PAD exhibit significant racial and ethnic disparities.
- Understanding these disparities is crucial for targeted interventions.
Purpose of the Study:
- To investigate racial disparities in lower-extremity amputation rates among Native American patients with PAD.
- To identify sociodemographic, clinical, and hospital-level factors contributing to these disparities.
- To compare amputation rates between Native Americans and non-Hispanic Whites.
Main Methods:
- Analysis of Healthcare Cost and Utilization Program inpatient discharge data (2006-2013).
- Inclusion of patients with a primary diagnosis of PAD.
- Application of multivariable models and Blinder-Oaxaca decomposition to assess covariate impacts.
Main Results:
- Native Americans in the West Census Region were twice as likely to undergo amputation compared to non-Hispanic Whites.
- Regional differences significantly influenced amputation likelihood.
- Disparities remained substantial after adjusting for multiple factors.
Conclusions:
- Native Americans with PAD in the West Census Region experience disproportionately higher amputation rates.
- Sociodemographic, comorbidity, and hospital factors do not fully explain this regional disparity.
- Targeted strategies are needed to address geographic and racial inequities in PAD care.
Introduction:
This study analyzed the impact of sociodemographic characteristics, patient comorbidities, risk factors for critical limb ischemia and hospital characteristics on racial disparities in amputation rates for Native American patients with peripheral artery disease (PAD).
Methods:
The study used the Healthcare Cost and Utilization Program inpatient discharge data from 2006-2013 for patients with a primary diagnosis of PAD. Multivariable models using the Blinder-Oaxaca decomposition method were estimated to isolate the impact of individual covariates to identify determinants of amputation rates for Native Americans compared with non-Hispanic Whites.
Results:
Region of the country made a difference in this analysis with Native Americans residing in the West Census Region being twice as likely to undergo amputation as non-Hispanic Whites.
Conclusions:
After adjusting for sociodemographic characteristics, patient comorbidities, and hospital characteristics, Native Americans with PAD who reside in the West Census Region are substantially more likely to undergo amputation than are non-Hispanic Whites.
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