Healthcare Disparities in Interventional Radiology.

We read with interest the article by Williams et al [ 1 Williams A.O. Sridharan N. Rojanasarot S. et al. Population-based disparities in inferior vena cava filter procedures among Medicare enrollees with acute venous thromboembolism. J Am Coll Radiol. 2022; 19: 722-732 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar ]. It identifies unfair differences in health care access to a vena cava filter (IVCF) in venous thromboembolisms (VTEs), as well as its timely withdrawal, according to county, sex, and type of health service. We find the exercise very interesting; it has been carried out in the context of the Medicare program, which seeks total coverage and appropriate health care for the population in vulnerable conditions. It seems pertinent to us to share that the health care system in Colombia is based on universal coverage and access for its entire population. By the year 2022, 98.78% of the Colombian population will be affiliated to the system [ 2 Así vamos en Salud. Aseguramiento-Georeferenciado. https://www.asivamosensalud.org/indicadores/aseguramiento/aseguramiento-georeferenciadoDate accessed: June 8, 2022 Google Scholar ], which is financed by different taxes adjusted for income and wealth from individuals and legal entities. Although the overall coverage is good, there are certain departments (equivalent to US states) where it is far below the ideal. It should be noted that even with adequate coverage indicators, users may face access barriers due to remote geographic locations, referral to providers with low technical-scientific capacity, or other inequities based on gender, ethnicity, territory (urban, suburban, or rural), and health system affiliation status. Population-Based Disparities in Inferior Vena Cava Filter Procedures Among Medicare Enrollees With Acute Venous ThromboembolismJournal of the American College of RadiologyVol. 19Issue 6PreviewVenous thromboembolism (VTE) imposes a significant clinical and financial burden on patients and society. Inferior vena cava filters (IVCFs) are considered for patients with absolute contraindications or failures of anticoagulation. However, studies examining the population-based disparities of IVCF placement and retrieval are limited. The association between patient and clinical characteristics in the likelihood of and time to IVCF placement and retrievals in a nationally representative cohort was examined. Full-Text PDF Open Access 

Access to the Vena Cava Filter: More Than a Disparity.

Vena-Cava-Filter

PurposeVenous thromboembolism (VTE) imposes a significant clinical and financial burden on patients and society. Inferior vena cava filters (IVCFs) are considered for patients with absolute contraindications or failures of anticoagulation. However, studies examining the population-based disparities of IVCF placement and retrieval are limited. The association between patient and clinical characteristics in the likelihood of and time to IVCF placement and retrievals in a nationally representative cohort was examined.MethodsMedicare patients aged ≥65 years with index VTE claims between 2015 and 2018 were followed through 2019 to identify IVCF placements and retrievals. Rates were compared using survival analysis methods.ResultsOf the 516,978 patients with VTE diagnoses, 5,864 (1.1%) had IVCFs placed, and 1,884 (32.1%) of those underwent retrieval procedures. Placement and retrieval rates varied significantly by demographics, comorbidity burden, and geographic region. From Cox regression, older age (hazard ratio [HR], 1.26; P < .0001), higher baseline comorbidity (Elixhauser) score (HR, 1.07; P < .0001), and outpatient (vs inpatient) site of VTE service (HR, 2.11; P < .0001) were associated with increased frequency of IVCF placement. The rate of retrieval was significantly lower for men (HR, 0.83; P = .0393), patients with higher comorbidity scores (HR, 0.95; P = .0037), and those with outpatient (vs inpatient) VTE sites of service (HR, 0.77; P = .0173). Neither facility- nor county-level characteristics were significantly associated with placements or retrievals.ConclusionsThis large cohort of Medicare beneficiaries with newly diagnosed VTE demonstrated inequities in IVCF placement and retrieval. 

W. Wifler

Papers

Population-Based Disparities in Inferior Vena Cava Filter Procedures Among Medicare Enrollees With Acute Venous Thromboembolism.

P32 Price Analysis of Cancer Therapies for the Treatment of Patients with Unresectable Hepatocellular Carcinoma

POSB226 Variations in Inferior Vena Cava Filter Placement Among Medicare Beneficiaries with Acute Venous Thromboembolism

POSB124 Costs of Inferior Vena Cava Filter Placement for Medicare Beneficiaries with Acute Venous Thromboembolism

Cost Burden and Cost Influencers of Inferior Vena Cava Filter Placement and Retrieval Among Medicare Beneficiaries with Acute Venous Thromboembolism.