Evidence map›Paper›PMID 33993721›Full record

ArticleCirculation. Heart failure2021

Association of Health Insurance Payer Type and Outcomes After Durable Left Ventricular Assist Device Implantation: An Analysis of the STS-INTERMACS Registry.

Sameed Ahmed M Khatana, Thomas C Hanff, Ashwin S Nathan, Elias J Dayoub, E Wilson Grandin, J Eduardo Rame, Alexander C Fanaroff, Jay Giri, Peter W Groeneveld

Abstract read
In one paragraph

Article in Circulation. Heart failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Sameed Ahmed M KhatanaDivision of Cardiovascular Medicine (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G.), Perelman School of Medicine, University of Pennsylvania, PA.
Thomas C HanffDivision of Cardiovascular Medicine (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G.), Perelman School of Medicine, University of Pennsylvania, PA.
Ashwin S NathanDivision of Cardiovascular Medicine (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G.), Perelman School of Medicine, University of Pennsylvania, PA.
Elias J DayoubDivision of Cardiovascular Medicine (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G.), Perelman School of Medicine, University of Pennsylvania, PA.
E Wilson GrandinRichard A. and Susan F. Smith Center for Outcomes Research in Cardiology (E.W.G.), Beth Israel Deaconess Medical Center, Boston, MA.
J Eduardo RameJefferson Heart Institute, Thomas Jefferson University Hospital, Pennsylvania, PA (J.E.R.).
Alexander C FanaroffDivision of Cardiovascular Medicine (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G.), Perelman School of Medicine, University of Pennsylvania, PA.
Jay GiriDivision of Cardiovascular Medicine (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G.), Perelman School of Medicine, University of Pennsylvania, PA.
Peter W GroeneveldPenn Cardiovascular Outcomes, Quality, & Evaluative Research Center (S.A.M.K., T.C.H., A.S.N., E.J.D., A.C.F., J.G., P.W.G.), Perelman School of Medicine, University of Pennsylvania, PA.

Funding

Association of Health Insurance with Access to Cardiovascular CareK23HL153772 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI KHATANA, SAMEED AHMED MUSTAFA · 2020 to 2024
$981k
NHLBI NIH HHS K23 HL153772
6 · The paper itself

Abstract

backgroundDue to the high cost of left ventricular assist device (LVAD) therapy, payer type may be an important factor in determining eligibility. How payer type influences outcomes after LVAD implantation is unclear. We, therefore, aimed to study the association of health insurance payer type with outcomes after durable LVAD implantation.

methodsUsing STS-INTERMACS (Society of Thoracic Surgeons-Interagency Registry for Mechanically Assisted Circulatory Support), we studied nonelderly adults receiving a durable LVAD from 2016 to 2018 and compared all-cause mortality and postindex hospitalization adverse event episode rate by payer type. Multivariable Fine-Gray and generalized linear models were used to compare the outcomes.

resultsOf the 3251 patients included, 26.0% had Medicaid, 24.9% had Medicare alone, and 49.1% had commercial insurance. Compared with commercially insured patients, mortality did not differ for patients with Medicaid (subdistribution hazard ratio, 1.00 [95% CI, 0.75-1.34],

conclusionsAll-cause mortality after durable LVAD implantation did not differ significantly by payer type. Payer type was associated with the rate of adverse events, with Medicaid associated with a significantly lower rate, and Medicare with a significantly higher rate of adverse event episodes compared with commercially insured patients.

Indexed as

Insurance, HealthAdultAgedFemaleHeart-Assist DevicesHeart FailureHospitalizationHumansIncidenceMaleMedicareMiddle AgedRegistriesRetrospective StudiesUnited Stateshealth insuranceheart-assist devicesheart failureMedicaidMedicarequality of health care

Identifiers

PMID33993721
PMCPMC8153026

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.