Publications by authors named "Lauren A Eberly"
Background: Incarcerated individuals have a disproportionate burden of cardiovascular risk factors. However, there is a paucity of data focusing on cardiovascular death and access to adequate health care among incarcerated individuals.
Methods: We used the Mortality in Correctional Institutions database from the US Bureau of Justice Statistics to examine cardiovascular deaths in all state prisons from 2001 to 2019, health care provision, as well as differences in these measures between racial and ethnic groups.
Background: Cardiac amyloidosis (CA) is an underdiagnosed cause of heart failure with a poor prognosis if left untreated. Echocardiography provides an excellent screening tool, but it is unknown how frequently patients with features consistent with CA undergo further testing.
Methods: The study aims to investigate the rates of cardiac MRI (CMR) and PYP scan utilization and identify the clinical and echocardiographic factors associated with their use.
Background: The American Indian population in the United States experiences marked cardiovascular health disparities. American Indian patients, particularly those receiving care rurally through the Indian Health Service (IHS), face unique challenges to accessing appropriate cardiovascular care. However, there are no studies in the current era characterizing these challenges from the patient perspective.
View Article and Find Full Text PDFBackground: The 2021 Price Transparency Rule was implemented to increase market competition, facilitate price shopping, and reduce prices and health care costs. We sought to measure inter- and intrahospital variation in prices, measure price variation across payer types, and identify hospital characteristics associated with increased commercial prices for 16 common cardiovascular admission diagnoses, diagnostic tests, and therapeutic procedures.
Methods And Results: Prices were obtained from Turquoise Health, a platform that aggregates hospital prices from publicly available machine-readable files, for each diagnosis, test, and procedure based on () and () codes.
Objective: Peripheral artery disease (PAD) affects >12 million Americans and poses significant financial burdens on patients, but the relationship between delayed/forgone (D/F) care and resource use in this population is unknown. We sought to assess the relationship between D/F care, resource use, and health care expenditures among patients with PAD.
Methods: Adults with PAD in the United States were identified in the Medical Expenditure Panel Survey for years 2007 to 2017.
Racial, Socioeconomic, and Geographic Disparities in Preamputation Vascular Care for Patients With Chronic Limb-Threatening Ischemia.
Circ Cardiovasc Qual Outcomes
January 2025
Background: Black patients, those with low socioeconomic status (SES), and those living in rural areas have elevated rates of major lower extremity amputation, which may be related to a lack of subspecialty chronic limb-threatening ischemia care. We evaluated the association between race, rurality, SES, and preamputation vascular care.
Methods: Among patients aged 66 to 86 years with fee-for-service Medicare who underwent major lower extremity amputation for chronic limb-threatening ischemia from July 2010 to December 2019, we compared the proportion who received vascular care in the 12 months before amputation by race (Black versus White), rurality, and SES (dual eligibility for Medicaid versus no dual eligibility) using multivariable logistic regression adjusting for clinical and demographic covariates.
Article Synopsis
- - We analyzed the revenues, costs, and contribution margins (CMs) for major cardiovascular procedures in Medicare patients from 2016 to 2019, focusing on how these factors differ across various procedures.
- - Claim-level costs were determined using cost-to-charge ratios, and outliers were adjusted for accuracy, which helped us calculate the CMs as the difference between revenue and costs.
- - Our findings showed significant variation in revenues, costs, and CMs for different cardiovascular procedures, with those procedures that are increasingly common generating substantial net CMs for hospitals in the US.
Background: Hospitals and health systems must balance the demand for transcatheter aortic valve replacement (TAVR) against financial sustainability. Patients may be eligible for both TAVR and surgical aortic valve replacement (SAVR), but financial realities for hospitals may affect differential access to those therapies. We sought to understand the landscape of costs and reimbursement for TAVR and SAVR in the US and to understand the association of procedural reimbursement with receipt of either.
View Article and Find Full Text PDFAssociation of Homelessness and Unstable Housing With Cardiovascular Care Utilization Among Veterans.
Circ Cardiovasc Qual Outcomes
November 2024
Background: Veterans are disproportionately more likely to experience homelessness and unstable housing (HUH) compared with the general population. Cardiovascular disease is the leading cause of death among Veterans experiencing HUH. We aimed to understand whether HUH status among Veterans with preexisting cardiovascular disease was associated with disparities in cardiovascular care access and utilization.
View Article and Find Full Text PDFImportance: Extreme heat in the US is increasing due to climate change, while extreme cold is projected to decline. Understanding how extreme temperature along with demographic changes will affect population health is important for devising policies to mitigate the health outcome of climate change.
Objective: To assess the burden of extreme temperature-related deaths in the contiguous US currently (2008-2019) and estimate the burden in the mid-21st century (2036-2065).
Racial, Ethnic, Socioeconomic, and Geographic Inequities in Access to Mechanical Circulatory Support.
J Soc Cardiovasc Angiogr Interv
January 2024
Background: Hospital admissions for cardiogenic shock have increased in the United States. Temporary mechanical circulatory support (tMCS) can be used to acutely stabilize patients. We sought to evaluate the presence of racial, ethnic, and socioeconomic inequities in access to MCS in the United States among patients with cardiogenic shock.
View Article and Find Full Text PDFArticle Synopsis
- The underutilization of guideline-directed medical therapy for heart failure with reduced ejection fraction among American Indian patients is linked to limited access to cardiology care, particularly in the Navajo Nation.
- The study aimed to evaluate whether a telehealth model could enhance the use of guideline-directed medical therapy by initiating and adjusting treatment over the phone while using remote monitoring tools.
- The Hózhó randomized clinical trial involved 103 patients and sought to measure the increase in the number of prescribed drug classes within 30 days after randomization, revealing important insights into the effectiveness of telehealth in improving heart failure management.
Medicaid Expansion And Outpatient Cardiovascular Care Use Among Low-Income Nonelderly Adults, 2012-15.
Health Aff (Millwood)
November 2023
Article Synopsis
- * A study compared data from states that expanded Medicaid (New Jersey and Minnesota) to those that did not (Georgia and Tennessee) between 2012 and 2015.
- * Findings revealed a 38.1% increase in outpatient visits for cardiovascular care and a 42.9% increase in prescriptions for cardiovascular treatments in states that expanded Medicaid, indicating that the expansion was effective in improving access to care for low-income individuals.
Background: Climate change is causing an increase in extreme heat. Individuals with cardiovascular disease are at high risk of heat-related adverse health effects. How the burden of extreme heat-associated cardiovascular deaths in the United States will change with the projected rise in extreme heat is unknown.
View Article and Find Full Text PDFArticle Synopsis
- * A study analyzed Medicare data from 2015 to 2019 to evaluate the incidence, prevalence, and mortality of various heart conditions among American Indian and Alaska Native patients aged 65 and older.
- * Among the 220,598 participants, high rates of diabetes (44.8%), hyperlipidemia (61.3%), and hypertension (72.2%) were found, with evidence of worsening heart health indicators, such as an increase in myocardial infarction rates and consistent prevalence of coronary artery disease over the study period.
Article Synopsis
- Inadequate representation of older patients, women, and racial and ethnic minorities in cardiovascular clinical trials hampers the applicability of findings and access to new treatments.
- A study analyzed 139 clinical trials on valvular heart disease from 2005 to 2020 to assess the trends in the inclusion of these underrepresented groups.
- Results showed that while the average age of participants slightly increased, the proportion of women remained steady at 41.1%, and racial/ethnic data was reported in only 9.4% of trials, with no significant changes in minority representation over time.
Background: Racial residential segregation is associated with racial health inequities, but it is unclear if segregation may exacerbate Black-White disparities in cardiovascular disease (CVD) mortality. This study aimed to assess associations between Black-White residential segregation, CVD mortality rates among non-Hispanic (NH) Black and NH White populations, and Black-White disparities in CVD mortality.
Methods: This cross-sectional study analyzed Black-White residential segregation, as measured by county-level interaction index, of US counties, county-level CVD mortality among NH White and NH black adults aged 25 years and older, and county-level Black-White disparities in CVD mortality in years 2014 to 2017.
Article Synopsis
- The study analyzed the use of medical devices and outcomes related to lower extremity peripheral arterial interventions for different racial groups using data from the American College of Cardiology National Cardiovascular Data Registry from 2014 to 2019.
- It found that while Black patients had higher rates of specific health conditions and socio-economic challenges, they received drug-eluting technologies more often than White patients, but there were no significant differences in the use of atherectomy or intravascular imaging.
- Interestingly, Black patients were less likely to undergo surgical or repeat procedures after 1 year, although there were no differences in mortality or major amputations between the groups.
Article Synopsis
- The prevalence of Type 2 diabetes and heart failure in the U.S. is increasing, and while GLP-1 receptor agonists and SGLT2 inhibitors help improve patient outcomes, high medication costs may lead to lower adherence to these treatments.
- This study examined the impact of prescription co-payment levels on adherence to GLP-1 and SGLT2 therapies over one year, using data from individuals with T2D and/or heart failure who had prescription claims from early 2014 to late 2020.
- Results showed that individuals facing medium or high co-pays were significantly less likely to adhere to their medication regimen, with only 65.3% of GLP-1 users and
Background Inequitable access to high-technology therapeutics may perpetuate inequities in care. We examined the characteristics of US hospitals that did and did not establish left atrial appendage occlusion (LAAO) programs, the patient populations those hospitals served, and the associations between zip code-level racial, ethnic, and socioeconomic composition and rates of LAAO among Medicare beneficiaries living within large metropolitan areas with LAAO programs. Methods and Results We conducted cross-sectional analyses of Medicare fee-for-service claims for beneficiaries aged 66 years or older between 2016 and 2019.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates the impact of having sinus rhythm (SR) at the time of catheter ablation (CA) on long-term outcomes for patients with persistent atrial fibrillation (PersAF).
- Results show that patients who presented in SR had better freedom from atrial arrhythmias (AAs) after the procedure compared to those who presented in atrial fibrillation (AF).
- The findings suggest that achieving SR before ablation can improve overall arrhythmia outcomes and prolong the time until recurrent AF.
Article Synopsis
- Racial and ethnic minorities, along with socioeconomically disadvantaged patients, are often underrepresented in clinical trials, prompting a need for better inclusivity efforts.
- The study aimed to examine differences in the racial, ethnic, and socioeconomic demographics of patients at US hospitals participating in clinical trials for new transcatheter therapies versus those that did not.
- Findings revealed that hospitals involved in trials had patients with higher average household incomes and lower levels of community distress, indicating disparities in access to clinical trial participation.
Article Synopsis
- Postpartum cardiovascular evaluations for women with preeclampsia are crucial for managing risk factors that could lead to long-term heart issues, yet many patients miss in-person follow-up visits.
- A study compared completion rates for postpartum hypertension management via telemedicine versus traditional in-person visits, finding a 32% completion rate for in-person visits compared to 70% for telemedicine.
- The results showed that younger and Black women were less likely to attend in-person visits, suggesting telemedicine could be a more effective way to reach and manage care for these at-risk populations.