Investigators from Duke University Target Pulmonary Hypertension (Health Insurance and Racial Disparities in Pulmonary Hypertension Outcomes)

By a News Reporter-Staff News Editor at Insurance Weekly News -- Investigators discuss new findings in Lung Diseases and Conditions - Pulmonary Hypertension. According to news reporting originating from Durham, North Carolina, by VerticalNews correspondents, research stated, "Pulmonary hypertension portends a poorer prognosis for blacks versus white populations, but the underlying reasons are poorly understood. We investigated associations of disease characteristics, insurance status, and race with clinical outcomes."

Our news editors obtained a quote from the research from Duke University, "Retrospective cohort study of patients presenting for initial pulmonary hypertension evaluation at 2 academic referral centers. We recorded insurance status (Medicare, Medicaid, private, self-pay), echocardiographic, and hemodynamics data from 261 patients (79% whites, 17% blacks) with a new diagnosis of pulmonary hypertension. Subjects were followed for 2.3 years for survival. Adjustment for covariates was performed with Cox proportional hazards modeling. Compared with white patients, blacks were younger (50 +/- 15 vs 53 +/- 12 years; P=.04), with females representing a majority of patients in both groups (80% vs 66%; P=.08) and similar functional class distribution (class 2/3/4: 30%/52%/16% blacks vs 33%/48%/14% whites; P=.69). Blacks diagnosed with incident pulmonary hypertension were more frequently covered by Medicaid (12.5% vs 0.7%) and had less private insurance (50% vs 61%; P=.007) than whites. At presentation, blacks had more right ventricular dysfunction (P=.04), but similar mean pulmonary arterial pressure (46 vs 45 mm Hg, respectively; P=.66). After adjusting for age and functional class, blacks had greater mortality risk (hazard ratio [HR], 2.06; 95% confidence interval [CI], 1.18-3.44), which did not differ by race after additional adjustment for insurance status (HR, 1.74; 95% CI, 0.84-3.32; P=.13). In a large cohort of patients with incident pulmonary hypertension, black patients had poorer right-side heart function and survival rates than white patients."

According to the news editors, the research concluded: "However, adjustment for insurance status in our cohort removed differences in survival by race."

For more information on this research see: Health Insurance and Racial Disparities in Pulmonary Hypertension Outcomes. American Journal of Managed Care, 2017;23(8):474-480. American Journal of Managed Care can be contacted at: Managed Care & Healthcare Communications Llc, 666 Plainsboro Rd, Ste 300, Plainsboro, NJ 08536, USA.

The news editors report that additional information may be obtained by contacting R.A. Krasuski, Duke University, Medical Center, Div Cardiol, Durham, NC 27710, United States. Additional authors for this research include K.A. Stackhouse, S.A. Hart, T.M. Bashore and K.S. Parikh.

Keywords for this news article include: Durham, North Carolina, United States, North and Central America, Cardiovascular Diseases and Conditions, Medicaid, Risk and Prevention, Lung Diseases and Conditions, Pulmonary Hypertension, Health Insurance, Health Policy, Duke University.

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