Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease (Oct 2020)

Disparities in the Management of Newly Diagnosed Paroxysmal Supraventricular Tachycardia for Women Versus Men in the United States

  • Naomi C. Sacks,
  • Katie Everson,
  • Maia R. Emden,
  • Phillip L. Cyr,
  • David R. Wood,
  • Sajjad Raza,
  • Kathryn A. Wood,
  • Sean D. Pokorney

DOI
https://doi.org/10.1161/JAHA.120.015910
Journal volume & issue
Vol. 9, no. 19

Abstract

Read online

Background Information on differences in paroxysmal supraventricular tachycardia (PSVT) diagnosis, healthcare resource use, expenditures, and treatment among women versus men is limited. Methods and Results Study participants identified in the IBM MarketScan Commercial Research Databases were aged 18 to 40 years with newly diagnosed PSVT (International Classification of Diseases, Ninth Revision [ICD‐9]: 427.0; International Classification of Diseases, Tenth Revision [ICD‐10]: I47.1) from October 1, 2012, through September 30, 2016, observable 1 year preindex and postindex diagnosis. Study outcomes were mean annual per‐patient healthcare resource use and expenditures before and after diagnosis. Among 5466 patients newly diagnosed with PSVT, most (66.9%) were women. Compared with men, women with PSVT tended to have higher rates of anxiety (13.9% versus 10.9%; P<0.01) and chronic pulmonary disease (10.9% versus 8.3%; P<0.01). Following diagnosis, mean annual per‐patient expenditures increased for all patients, but were significantly lower for women ($26 922 versus $33 112; P<0.05), reflecting lower spending for services billed as a result of a PSVT diagnosis ($8471 versus $11 405; P<0.05). After diagnosis, nearly half of all patients had at least 1 emergency department visit (women versus men, 49.6% versus 44.5%; P<0.01) and more had hospital admissions (women versus men, 24.7% versus 20.0%; P<0.01). Fewer women were treated with cardiac ablation (12.6% versus 15.3%; P<0.01), and more were treated with medical therapy, including β blockers or calcium channel blockers (odds ratio, 1.15; 95% CI, 1.02–1.31). Conclusions Among patients aged 18 to 40 years, ≈2 of 3 patients diagnosed with PSVT were women. After diagnosis, spending was significantly lower for women, reflecting lower ablation rates and less spending on services with a PSVT diagnosis.

Keywords