UNASSIGNED: Patients (aged ≥18 years) had ≥1 pharmacy claim for PAH medication, ≥6 months\' continuous healthcare plan enrollment, ≥1 inpatient/outpatient medical claim with a pulmonary hypertension diagnosis ≤6 months before first PAH medication, and race recorded.
UNASSIGNED: This analysis included 836 Black and 2896 White patients. Black patients were younger, with lower levels of education and annual household income, and higher comorbidity scores versus White patients. Only ∼14% of Black and White patients received index combination therapy. Lower adherence to index treatment was observed in Black patients. Although adjusted regression analysis in the overall population showed no differences in outcomes between groups, Black patients <65 years were 36% less likely to receive index combination therapy (odds ratio [OR] 0.64; 95% confidence interval [CI] 0.41-0.99), and 46% less likely to adhere to index treatment (OR 0.54; 95% CI 0.33-0.90). Other disparities included 24% higher all-cause health care resource utilization, 75% higher all-cause costs, and higher risk of clinical composite outcome. Social determinants of health (education, income, health insurance plan) partially mediated these race effects.
UNASSIGNED: Differences in demographics, clinical characteristics, and treatment patterns between Black and White patients with PAH were observed. Disparities between Black and White patients <65 years were only partially mediated through social determinants of health variables, suggesting other factors may be involved.
■患者(年龄≥18岁)对PAH药物的药学要求≥1,≥6个月连续医疗计划登记,首次PAH药物治疗前≥6个月,诊断为肺动脉高压的住院/门诊医疗索赔,和种族记录。
■该分析包括836名黑人和2896名白人患者。黑人患者更年轻,教育水平和家庭年收入较低,与白人患者相比,合并症评分更高。只有14%的黑人和白人患者接受了指数联合治疗。在Black患者中观察到对指数治疗的依从性较低。尽管在总体人群中进行的调整回归分析显示两组之间的结果没有差异,<65岁的黑人患者接受指数联合治疗的可能性降低了36%(比值比[OR]0.64;95%置信区间[CI]0.41-0.99),接受指数治疗的可能性降低了46%(OR0.54;95%CI0.33-0.90)。其他差距包括全因医疗保健资源利用率提高24%,全因成本提高75%,和更高的临床复合结局的风险。健康的社会决定因素(教育,收入,健康保险计划)部分介导了这些种族效应。
■人口统计学差异,临床特征,观察了黑白PAH患者的治疗模式。65岁以下的黑人和白人患者之间的差异仅部分通过健康变量的社会决定因素介导,这表明可能涉及其他因素。