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

Abstract

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.

Health care centre and emergency department utilization by patients with episodes of tachycardia

“…A clear difference was observed between sexes; of the 10,000 inhabitants, 151 females and 73 males had visited a health care facility at least once because of the condition (p < 0.01). The result can be interpreted in relation to earlier research showing that the incidence of SVT is slightly higher in females than in males [11,12,21]. Furthermore, health care utilization in HCCs [21,26] and EDs [27] is more common among females.…”

“…The result can be interpreted in relation to earlier research showing that the incidence of SVT is slightly higher in females than in males [11,12,21]. Furthermore, health care utilization in HCCs [21,26] and EDs [27] is more common among females. The total per capita cost for health care is higher for females, with a cost difference of 8% after adjusting for reproduction and sex-specific morbidity [26].…”

“…Previous research has reported the consequences for both patients and society due to repeated visits to a health care facility [8]. Effective management of SVT, such as early identification and response to symptoms, may substantially affect health care utilization for this group of patients [2,21].…”

“…Catheter ablation therapy represents a potentially curative therapy, with a 95-97% success rate for AVNRT and a 95% rate for AVRT [1,14,18], compared to lifelong drug treatment [1,18]. Following catheter ablation, a significant improvement is observed in a variety of symptoms and quality of life indices [10,13,19], as well as decreases in medical and health care costs [20,21]. However, studies of health care utilization at both HCCs and EDs for outpatients with episodes of tachycardia (potential SVT) are limited [5,15].…”

“…However, studies of health care utilization at both HCCs and EDs for outpatients with episodes of tachycardia (potential SVT) are limited [5,15]. Hence, effective management of outpatients with tachycardia may substantially affect the utilization of health care resources [2,21]. This study aimed to explore health care utilization by outpatients with episodes of tachycardia visiting HCCs and/or EDs.…”