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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Sex-Based Disparities in Health Care Access and Utilization Among Patients With Atrial Fibrillation
Ji Mei May Wong1, Peter R Kowey2,3
1Department of Internal Medicine, Lankenau Medical Center, Wynnewood, Pennsylvania.
JAMA Network Open
|June 25, 2026
Summary
Females with atrial fibrillation (AF) face more healthcare access barriers than males, particularly concerning medication costs and provider visits. These disparities may contribute to worse AF outcomes in women.
Area of Science:
- Cardiology and Health Services Research
- Investigating sex-based disparities in healthcare access and utilization (HCAU) among patients with atrial fibrillation (AF).
- Examining the impact of HCAU barriers on clinical outcomes in a diverse patient population.
Background:
- Females with AF have higher risks of stroke, myocardial infarction, and mortality compared to males.
- Existing theories attribute these sex-based differences to hormonal, structural, and electrophysiologic factors.
- This study explores sex-based differences in HCAU as potential underlying factors for outcome disparities.
Purpose of the Study:
- To determine if sex-based disparities in HCAU barriers exist among individuals diagnosed with AF.
- To quantify the differences in reported HCAU barriers between males and females with AF.
Main Methods:
- Cross-sectional study utilizing the All of Us Research Program Registered Tier dataset (version 8).
- Included 12,428 adult patients with a SNOMED diagnosis of AF and completed HCAU survey.
- Analyzed associations between sex at birth and 20 HCAU outcomes using multivariable logistic regression and marginal standardization.
Main Results:
- Females with AF reported significantly higher HCAU barriers for 14 out of 20 outcomes compared to males.
- Key differences included cost-related medication access/adherence and nervousness about healthcare visits.
- Females were more likely to report issues affording medications, delaying fills, and asking for lower-cost options.
Conclusions:
- Females with AF experience a greater burden of HCAU barriers than males.
- These HCAU disparities may partially explain the observed sex-based differences in AF-related clinical outcomes.
- Addressing these barriers is crucial for improving cardiovascular health equity in women with AF.
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