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• W4362584211 abstract "PurposeThere are limited data depicting access to advanced heart failure (AHF) therapies by race/ethnicity. We aimed to determine the actual-to-expected utilization of AHF therapies in the United States (US) across racial/ethnic groups.MethodsThe actual allocation of AHF therapies was obtained from the United Network for Organ Sharing database and the Interagency Registry for Mechanically Assisted Circulatory Support database from 2015 - 2019. The expected allocation of AHF therapies was estimated using 1) current US census data, 2) prevalence of heart failure (HF) among racial/ethnic groups, 3) prevalence of AHF within the HF population, and 4) the assumption that the allocation of AHF therapies within racial/ethnic groups will be proportional to the overall allocation (accounting for equal access to care) of therapies in the US. Next, we calculated the actual-to-expected ratios (reported as percentages) of AHF therapies (AHFT).ResultsAssuming the prevalence of AHF among HF patients is 10% and ∼50% have reduced ejection fraction, then 310,000 people in the US have AHF that could necessitate AHFT. The average annual volumes of left ventricular assist devices (LVADs) and heart transplants (HT) were 2,921.4 LVADs and 3,239.8 HT (1.9% of the total AHF population). LVAD allocation was 63.1% White, 26.8% Black, 7% Hispanic and 3% Asian (1842, 782, 207, and 89 LVADs per year, respectively). HT allocation was 62.4% White, 22.5% Black, 11.2% Hispanic, 3.8% Asian (1994, 720, 357.6, and 121.4 HTs per year, respectively). Based on established rates of HF among each race/ethnicity (3.8% White, 6.9% Black, 4.1% Hispanic), 8, 046.5 LVADs and 6, 583.5 HTs in Whites, 2, 926 LVADs and 2, 394 HTs in Blacks, and 2, 612.5 LVADs and 2, 137.5 HTs in Hispanics were expected during the study period. The actual-to-expected ratios of AHF therapies are in Figure 1.ConclusionAlthough AHF therapies are underused in all races/ethnicities, there is greater disparity in access to AHF therapies among Hispanics than among Whites or Blacks. There are limited data depicting access to advanced heart failure (AHF) therapies by race/ethnicity. We aimed to determine the actual-to-expected utilization of AHF therapies in the United States (US) across racial/ethnic groups. The actual allocation of AHF therapies was obtained from the United Network for Organ Sharing database and the Interagency Registry for Mechanically Assisted Circulatory Support database from 2015 - 2019. The expected allocation of AHF therapies was estimated using 1) current US census data, 2) prevalence of heart failure (HF) among racial/ethnic groups, 3) prevalence of AHF within the HF population, and 4) the assumption that the allocation of AHF therapies within racial/ethnic groups will be proportional to the overall allocation (accounting for equal access to care) of therapies in the US. Next, we calculated the actual-to-expected ratios (reported as percentages) of AHF therapies (AHFT). Assuming the prevalence of AHF among HF patients is 10% and ∼50% have reduced ejection fraction, then 310,000 people in the US have AHF that could necessitate AHFT. The average annual volumes of left ventricular assist devices (LVADs) and heart transplants (HT) were 2,921.4 LVADs and 3,239.8 HT (1.9% of the total AHF population). LVAD allocation was 63.1% White, 26.8% Black, 7% Hispanic and 3% Asian (1842, 782, 207, and 89 LVADs per year, respectively). HT allocation was 62.4% White, 22.5% Black, 11.2% Hispanic, 3.8% Asian (1994, 720, 357.6, and 121.4 HTs per year, respectively). Based on established rates of HF among each race/ethnicity (3.8% White, 6.9% Black, 4.1% Hispanic), 8, 046.5 LVADs and 6, 583.5 HTs in Whites, 2, 926 LVADs and 2, 394 HTs in Blacks, and 2, 612.5 LVADs and 2, 137.5 HTs in Hispanics were expected during the study period. The actual-to-expected ratios of AHF therapies are in Figure 1. Although AHF therapies are underused in all races/ethnicities, there is greater disparity in access to AHF therapies among Hispanics than among Whites or Blacks." @default.
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• W4362584211 date "2023-04-01" @default.
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• W4362584211 title "(517) Actual-to-Expected Advanced Heart Failure Therapy Utilization in the United States by Race/Ethnicity" @default.
• W4362584211 doi "https://doi.org/10.1016/j.healun.2023.02.532" @default.
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