New Managed Care Findings Has Been Reported by Investigators at University of California Los Angeles (UCLA) (Demystifying the Outcome Disparities In Carotid Revascularization: Utilization of Experienced Centers): Managed Care

2022 NOV 03 (NewsRx) -- By a News Reporter-Staff News Editor at Hospital & Nursing Home Daily -- A new study on Managed Care is now available. According to news originating from Los Angeles, California, by NewsRx correspondents, research stated, “The present study examined race- and insurance-based disparities in utilization of high-volume centers for carotid revascularization. Adults (>= 18 years) undergoing carotid endarterectomy or carotid artery stenting were identified in the 2012-2019 National Inpatient Sample.”

Financial support for this research came from Dean’s Leadership in Health and Science Scholarship at the David Geffen School of Medicine at UCLA.

Our news journalists obtained a quote from the research from the University of California Los Angeles (UCLA), “Annual, institutional volume of carotid endarterectomy and carotid artery stenting were tabulated, and hospitals in the highest and lowest quartiles were considered high-volume centers and low-volume centers, respectively. Multivariable logistic models were developed to evaluate the association of race and insurance status with high-volume center utilization. Logistic and linear regression was used to examine the association of high-volume centers with outcomes of interest. Of an estimated 583,200 eligible patients, 60.3% underwent carotid revascularization at high-volume centers. Treatment at high-volume centers was associated with improved outcomes, including decreased odds of mortality/stroke/myocardial infarction (adjusted odds ratio 0.76, 95% confidence interval: 0.60-0.96) and a decrement in length of stay (beta: -0.19, 95% confidence interval: -0.25 to 0.12) and hospitalization costs by $2,000 (95% confidence interval: 1,800-2,300). After adjustment, Black (adjusted odds ratio 0.52, 95% confidence interval: 0.48-0.55), Hispanic (adjusted odds ratio 0.45, 95% confidence interval: 0.42-0.55), and other non-White patients (adjusted odds ratio 0.49, 95% confidence interval: 0.45-0.52) had lower odds of undergoing carotid revascularization at high-volume centers compared to White patients. Similarly, Medicaid (adjusted odds ratio 0.87, 95% confidence interval: 0.80-0.94) and lack of insurance (adjusted odds ratio 0.84, 95% confidence interval: 0.77-0.92) were associated with lower odds of high-volume center utilization relative to private insurance. Patients of color and those with Medicaid or lack of insurance used high-volume centers at lower rates.”

According to the news editors, the research concluded: “Further systemic efforts to ensure equitable access to experienced centers may reduce observed disparities in carotid revascularization.”

This research has been peer-reviewed.

For more information on this research see: Demystifying the Outcome Disparities In Carotid Revascularization: Utilization of Experienced Centers. Surgery, 2022;172(2):766-771. Surgery can be contacted at: Mosby-elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA. (Elsevier - www.elsevier.com; Surgery - http://www.journals.elsevier.com/surgery/)

The news correspondents report that additional information may be obtained from Peyman Benharash, University of California Los Angeles (UCLA), Division of Cardiac Surgery, Cardiovasc Outcomes Res Labs, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, United States. Additional authors for this research include Russyan Mark Mabeza, Nikhil Chervu, Yas Sanaiha, Joseph Hadaya, Zachary Tran and Christian de Virgilio.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1016/j.surg.2022.03.043. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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