TY - JOUR
T1 - Delayed medical care due to transportation barriers among adults with atherosclerotic cardiovascular disease
AU - Acquah, Isaac
AU - Hagan, Kobina
AU - Valero-Elizondo, Javier
AU - Javed, Zulqarnain
AU - Butt, Sara Ayaz
AU - Mahajan, Shiwani
AU - Taha, Mohamad Badie
AU - Hyder, Adnan A.
AU - Mossialos, Elias
AU - Cainzos-Achirica, Miguel
AU - Nasir, Khurram
N1 - Funding Information:
Dr Nasir is on the advisory board of Amgen, Novartis, Medicine Company, and his research is partly supported by the Jerold B. Katz Academy of Translational Research. No other conflicts of interest relevant to the content of this manuscript were reported by the authors.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/3
Y1 - 2022/3
N2 - Background: In patients with atherosclerotic cardiovascular disease (ASCVD), barriers related to transportation may impair access to care, with potential implications for prognosis. Although few studies have explored transportation barriers among patients with ASCVD, the correlates of delayed care due to transportation barriers have not been examined in this population. We aimed to examine this in U.S. patients with ASCVD using nationally representative data. Methods: Using data from the 2009-2018 National Health Interview Survey, we estimated the self-reported prevalence of delayed medical care due to transportation barriers among adults with ASCVD, overall and by sociodemographic characteristics. Logistic regression was used to examine the association between various sociodemographic characteristics and delayed care due to transportation barriers. Results: Among adults with ASCVD, 4.5% (95% CI; 4.2, 4.8) or ∼876,000 annually reported delayed care due to transportation barriers. Income (low-income: odds ratio [OR] 4.43, 95% CI [3.04, 6.46]; lowest-income: OR 6.35, 95% CI [4.36, 9.23]) and Medicaid insurance (OR 4.53; 95% CI [3.27, 6.29]) were strongly associated with delayed care due to transportation barriers. Additionally, younger individuals, women, non-Hispanic Black adults, and those from the U.S. South or Midwest, had higher odds of reporting delayed care due to transportation barriers. Conclusions: Approximately 5% of adults with ASCVD experience delayed care due to transportation barriers. Vulnerable groups include young adults, women, low-income people, and those with public/no insurance. Future studies should analyze the feasibility and potential benefits of interventions such as use of telehealth, mobile clinics, and provision of transportation among patients with ASCVD in the U.S.
AB - Background: In patients with atherosclerotic cardiovascular disease (ASCVD), barriers related to transportation may impair access to care, with potential implications for prognosis. Although few studies have explored transportation barriers among patients with ASCVD, the correlates of delayed care due to transportation barriers have not been examined in this population. We aimed to examine this in U.S. patients with ASCVD using nationally representative data. Methods: Using data from the 2009-2018 National Health Interview Survey, we estimated the self-reported prevalence of delayed medical care due to transportation barriers among adults with ASCVD, overall and by sociodemographic characteristics. Logistic regression was used to examine the association between various sociodemographic characteristics and delayed care due to transportation barriers. Results: Among adults with ASCVD, 4.5% (95% CI; 4.2, 4.8) or ∼876,000 annually reported delayed care due to transportation barriers. Income (low-income: odds ratio [OR] 4.43, 95% CI [3.04, 6.46]; lowest-income: OR 6.35, 95% CI [4.36, 9.23]) and Medicaid insurance (OR 4.53; 95% CI [3.27, 6.29]) were strongly associated with delayed care due to transportation barriers. Additionally, younger individuals, women, non-Hispanic Black adults, and those from the U.S. South or Midwest, had higher odds of reporting delayed care due to transportation barriers. Conclusions: Approximately 5% of adults with ASCVD experience delayed care due to transportation barriers. Vulnerable groups include young adults, women, low-income people, and those with public/no insurance. Future studies should analyze the feasibility and potential benefits of interventions such as use of telehealth, mobile clinics, and provision of transportation among patients with ASCVD in the U.S.
KW - Atherosclerosis/epidemiology
KW - Cardiovascular Diseases/epidemiology
KW - Female
KW - Humans
KW - Income
KW - Medicaid
KW - Poverty
KW - United States/epidemiology
KW - Young Adult
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U2 - 10.1016/j.ahj.2021.11.019
DO - 10.1016/j.ahj.2021.11.019
M3 - Article
C2 - 34902312
AN - SCOPUS:85122035219
SN - 0002-8703
VL - 245
SP - 60
EP - 69
JO - American Heart Journal
JF - American Heart Journal
ER -