1. Clinician Specialty, Access to Care, and Outcomes Among Patients with Peripheral Artery Disease
- Author
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R. Casey Sullivan, Michelle M. Smerek, N. Chantelle Hardy, Manesh R. Patel, W. Schuyler Jones, E. Hope Weissler, Lesley H. Curtis, Dennis I. Narcisse, Steven J. Lippmann, Adam J. Brock, Melissa A. Greiner, Chandler A. Long, Cassie B. Ford, and Benjamin O’Brien
- Subjects
Male ,medicine.medical_specialty ,Specialty ,Disease ,Article ,Health Services Accessibility ,Cohort Studies ,Peripheral Arterial Disease ,Risk Factors ,Physicians ,medicine ,Humans ,Myocardial infarction ,Healthcare Disparities ,Stroke ,Aged ,Proportional Hazards Models ,Insurance, Health ,business.industry ,Endovascular Procedures ,General Medicine ,Middle Aged ,Vascular surgery ,medicine.disease ,United States ,Hospitalization ,Podiatrist ,Treatment Outcome ,Lower Extremity ,Social Class ,Cohort ,Emergency medicine ,Female ,business ,Medicaid - Abstract
BACKGROUND: Understanding the relationship between patterns of peripheral artery disease patterns and outcomes is an essential step towards improving care and outcomes. We hypothesized that clinician specialty would be associated with occurrence of major adverse vascular events (MAVE). METHODS: Patients with at least 1 peripheral artery disease-related encounter in our health system and fee-for-service Medicare were divided into groups based on the specialty of the clinician (cardiologist, surgeon, podiatrist, primary care, or other) providing a plurality of peripheral artery disease-coded care in the year prior to index encounter. The primary outcome was MAVE (a composite of all-cause mortality, myocardial infarction, stroke, lower extremity revascularization, and lower extremity amputation). RESULTS: The cohort included 1,768 patients, of whom 30.0% were Black, 23.9% were Medicaid dual-enrollment eligible, and 31.1% lived in rural areas. Patients receiving a plurality of their care from podiatrists had the highest 1-year rates of MAVE (34.4%, p
- Published
- 2022