{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T08:41:25Z","timestamp":1765960885174},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,10,8]],"date-time":"2015-10-08T00:00:00Z","timestamp":1444262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Michael Wolk Heart Foundation, New York Cardiac Center, Inc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study sought to identify the temporal trends of presenting diagnoses and vascular procedures performed for peripheral arterial disease (PAD) along with the rates of procedures and in\u2010hospital outcomes by payer status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Previous studies suggest that patients with Medicare, Medicaid, or lack of insurance receive poorer quality of care leading to worse outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed 196,461,055 discharge records to identify all hospitalized patients with PAD records (<jats:italic>n<\/jats:italic>\u2009=\u20091,687,724) from January 2007 through December 2011 in the Nationwide Inpatient Sample database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The annual frequency of vascular procedures remained unchanged during the study period. Patients with Medicaid were more likely to present with gangrenes, whereas patients with Medicare were more likely to present with ulcers. After adjustment, patients with Medicare and Medicaid were more likely to undergo amputations when compared with private insurance\/HMO (OR\u2009=\u20091.13, 95% CI\u2009=\u20091.10\u20131.16 and OR\u2009=\u20091.24, 95% CI\u2009=\u20091.20\u20131.29, respectively). Patients with both Medicare and Medicaid were less likely to undergo bypass surgery (OR\u2009=\u20090.82, 95% CI\u2009=\u20090.81\u20130.84 and OR\u2009=\u20090.87, 95% CI\u2009=\u20090.85\u20130.90, respectively), but more likely to undergo endovascular procedures (OR\u2009=\u20091.18, 95% CI\u2009=\u20091.17\u20131.20 and OR\u2009=\u20091.03, 95% CI\u2009=\u20091.01\u20131.06, respectively). Medicare and Medicaid status versus private insurance\/HMO was associated with worse adjusted odds of in\u2010hospital outcomes, including mortality after amputations, endovascular procedures, and bypass surgeries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this analysis, patients with Medicare and Medicaid had more comorbid conditions at baseline when compared with private insurance\/HMO cohorts, were more likely to present with advanced stages of PAD, undergo amputations, and develop in\u2010hospital complications. These data unveil a critical gap and an opportunity for quality improvement in the elderly and those with poor socioeconomic status. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.26065","type":"journal-article","created":{"date-parts":[[2015,10,8]],"date-time":"2015-10-08T06:44:48Z","timestamp":1444286688000},"page":"864-872","source":"Crossref","is-referenced-by-count":19,"title":["Trends in hospital treatments for peripheral arterial disease in the <scp>U<\/scp>nited <scp>S<\/scp>tates and association between payer status and quality of care\/outcomes, 2007\u20132011"],"prefix":"10.1002","volume":"86","author":[{"given":"Luke K.","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Cardiology Weill Cornell Medical College, New York Presbyterian Hospital New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajesh V.","family":"Swaminathan","sequence":"additional","affiliation":[{"name":"Division of Cardiology Weill Cornell Medical College, New York Presbyterian Hospital New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert M.","family":"Minutello","sequence":"additional","affiliation":[{"name":"Division of Cardiology Weill Cornell Medical College, New York Presbyterian Hospital New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher L.","family":"Gade","sequence":"additional","affiliation":[{"name":"Division of Cardiology Weill Cornell Medical College, New York Presbyterian Hospital New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David C.","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Cardiology Weill Cornell Medical College, New York Presbyterian Hospital New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Charitakis","sequence":"additional","affiliation":[{"name":"Division of Cardiology Weill Cornell Medical College, New York Presbyterian Hospital New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashish","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Cardiology Weill Cornell Medical College, New York Presbyterian Hospital New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Kaple","sequence":"additional","affiliation":[{"name":"Division of Cardiology Weill Cornell Medical College, New York Presbyterian Hospital New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoffrey","family":"Bergman","sequence":"additional","affiliation":[{"name":"Division of Cardiology Weill Cornell Medical College, New York Presbyterian Hospital New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harsimran","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Cardiology Weill Cornell Medical College, New York Presbyterian Hospital New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Chiu Wong","sequence":"additional","affiliation":[{"name":"Division of Cardiology Weill Cornell Medical College, New York Presbyterian Hospital New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dmitriy N.","family":"Feldman","sequence":"additional","affiliation":[{"name":"Division of Cardiology Weill Cornell Medical College, New York Presbyterian Hospital New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,10,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2004.06.072"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2006.07.015"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2005.11.002"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2004.02.039"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.01.035"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2005.12.002"},{"key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1001\/jama.1994.03510390039027","article-title":"Health care for black and poor hospitalized Medicare patients","volume":"271","author":"Kahn KL","year":"1994","journal-title":"JAMA"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.06.034"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2003.214"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.05.010"},{"key":"e_1_2_7_12_1","unstructured":"Healthcare Cost and Utilization Project (HCUP)\u2013Nationwide Inpatient Sample (NIS).Healthcare Cost and Utilization Project (HCUP) 2007\u20132009. 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