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Regional variations in cardiovascular risk factors and access to care among US veterans with cardiovascular disease
Pallavi Srivastava1, Javed Butler1, A Laurie Shroyer2,3
1Department of Medicine, Stony Brook University Medical Center, Stony Brook.
Insights
Regional variations exist in cardiovascular risk factors and healthcare access for US veterans with cardiovascular disease (CVD). Veterans in the Midwest and West regions reported fewer annual medical checkups compared to the Northeast.
Area of Science:
- Public Health
- Cardiovascular Medicine
- Health Services Research
Background:
- Understanding regional disparities in cardiovascular disease (CVD) care for US veterans is crucial.
- Previous research has not clearly defined variations in cardiovascular risk factors and healthcare access among US regions for veterans with CVD.
Purpose of the Study:
- To investigate regional differences in cardiovascular risk factors among US veterans.
- To assess variations in access to medical care, including financial barriers and annual checkups, for veterans with CVD across different US regions.
Main Methods:
- Utilized the 2016 Centers for Disease Control Behavioral Risk Factor Surveillance Survey to identify a cohort of US veterans with CVD.
- Categorized participants into four US regions: Northeast, Midwest, South, and West.
- Compared demographic data, medical history, financial barriers to care, and annual medical checkup rates across regions.
Main Results:
- Significant differences were observed in demographics, medical history, and access to care among veterans across the four US regions.
- Rates of financial barriers to medical care were comparable across all regions (approximately 7-8%).
- Veterans in the West region had the lowest rate of annual medical checkups (86.6%). The Midwest and West regions were independently associated with lower odds of having a medical checkup within the past year compared to the Northeast.
Conclusions:
- Significant regional variations exist in cardiovascular risk factors and the frequency of annual medical checkups among US veterans with CVD.
- While financial barriers to care were similar, access to routine checkups varied by region, particularly in the Midwest and West.
- Further research is needed to explore the prevalence of impaired access and quality of care in this population.
Background:
It remains unclear whether cardiovascular risk factors and access to healthcare for veterans with cardiovascular disease (CVD) vary among US regions. This study sought to determine the extent of regional variations in cardiovascular risk factors and access to medical care in a cohort of veterans with CVD in the USA.
Methods:
The 2016 Centers for Disease Control Behavioral Risk Factor Surveillance Survey was utilized to identify a cohort of veteran patients with CVD. Participants were classified based on four US regions: (1) Northeast, (2) Midwest, (3) South, and (4) West. We compared demographic data, medical history, and access to care for veterans of each US region. The outcomes of interest included financial barriers to medical care and annual medical checkup.
Results:
Among the 13 835 veterans, 18.3% were from the Northeast, while 23.5, 37.1, and 21.1% were from the Midwest, South, and West, respectively. Veterans of each region differed significantly with respect to demographic characteristics, prior medical history, and access to care. Rates of financial barriers to medical care were similar across the four regions (7.3 vs. 7.1 vs. 8.0 vs. 6.9%, P = 0.203). Veterans from the West had the lowest rates of medical checkup within the past year (91.7 vs. 89.5 vs. 91.4 vs. 86.6%). On multivariate analysis, the Midwest [odds ratio (OR) 0.69; 95% CI, 0.53-0.89] and West (OR 0.53; 95% CI 0.41-0.68) regions were independently associated with lower rates of medical checkup within the past year compared to the Northeast.
Conclusions:
In this observational study involving US veterans with CVD, cardiovascular risk factors and frequency of annual medical checkup differed amongst each US region. Further large-scale studies examining the prevalence of impaired access to care and quality of care in US veterans with CVD are warranted.
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