{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T16:11:18Z","timestamp":1777738278570,"version":"3.51.4"},"reference-count":9,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:00:00Z","timestamp":1616025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations\ufffd(Phila)"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We investigated health and healthcare disparities in the treatment of aortic stenosis with transcatheter aortic valve replacement (TAVR) and how they affect resource utilization and costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed all patients who were discharged alive after TAVR between 2012 and 2017 from the National Inpatient Sample. Patients were stratified by race and outcomes investigated were in-hospital complications, total procedural costs, and resource utilization. High resource utilization (HRU) was defined as length of stay (LOS) \u22657 days or discharge to a nonhome location. Multivariable regression models were used to identify predictors of HRU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>TAVR patients ( N = 29,464) were stratified into Caucasians ( n = 25,691), others ( n = 1,274), Hispanics ( n = 1,267), and African Americans (AA, n = 1,232). More AA and Hispanics had TAVR at urban teaching centers ( P = 0.003) and were less likely to be Medicare beneficiaries ( P &lt; 0.001). Distribution of TAVR patients in the lowest income quartile showed AA (50%) versus Caucasian (20%) versus Hispanic (33%, P &lt; 0.001). In-hospital complications were higher among Hispanics and AA than Caucasians with prolonged LOS, procedural costs, and HRU. On multivariable analysis, independent predictors of HRU were TAVR year ( P &lt; 0.001), advanced age ( P &lt; 0.001), female sex ( P &lt; 0.001), non-Caucasian race ( P = 0.038), history of coronary artery bypass grafting ( P &lt; 0.001), smoking ( P &lt; 0.001), chronic lung disease ( P = 0.003), stroke ( P &lt; 0.001), and lowest income quartile ( P = 0.002).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There exist significant healthcare and health disparities among patients undergoing TAVR in the United States. Consequently, this unequal access to care and determinants of heath translate into higher resource utilization and costs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1556984521996694","type":"journal-article","created":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T13:58:51Z","timestamp":1616075931000},"page":"262-266","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Health and Healthcare Disparities: Impact on Resource Utilization and Costs After Transcatheter Aortic Valve Replacement"],"prefix":"10.1177","volume":"16","author":[{"given":"Alexis K.","family":"Okoh","sequence":"first","affiliation":[{"name":"Department of Medicine, Rutgers Health: Newark Beth Israel Medical Center, Newark, NJ, USA"},{"name":"Department of Surgery, Division of Cardiac Surgery, Rutgers Robert Wood Johnson University Hospital, New Brunswick, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nehal","family":"Dhaduk","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School, Newark, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aakash M.","family":"Shah","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School, Newark, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Gold","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, University of Rhode Island College of Pharmacy, Kingston, RI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Setri","family":"Fugar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Rush University Medical Center, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Kassotis","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Rutgers Robert Wood Johnson University Hospital, New Brunswick, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunguang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiac Surgery, Rutgers Robert Wood Johnson University Hospital, New Brunswick, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonard Y.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiac Surgery, Rutgers Robert Wood Johnson University Hospital, New Brunswick, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark J.","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiac Surgery, Rutgers Robert Wood Johnson University Hospital, New Brunswick, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,3,18]]},"reference":[{"key":"bibr1-1556984521996694","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1814052"},{"key":"bibr2-1556984521996694","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.03.007"},{"key":"bibr3-1556984521996694","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.12.059"},{"key":"bibr4-1556984521996694","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2019.04.005"},{"key":"bibr5-1556984521996694","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2018.04.019"},{"key":"bibr6-1556984521996694","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-016-0325-x"},{"key":"bibr7-1556984521996694","unstructured":"American Heart Association. Cardiovascular disease: a costly burden for America, projections through 2035, https:\/\/healthmetrics.heart.org\/wp-content\/uploads\/2017\/10\/Cardiovascular-Disease-A-Costly-Burden.pdf (2017, accessed 30 October 2020)."},{"key":"bibr8-1556984521996694","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60236-X"},{"key":"bibr9-1556984521996694","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25535"}],"container-title":["Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1556984521996694","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1556984521996694","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1556984521996694","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:21:42Z","timestamp":1777461702000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1556984521996694"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,18]]},"references-count":9,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1177\/1556984521996694"],"URL":"https:\/\/doi.org\/10.1177\/1556984521996694","relation":{},"ISSN":["1556-9845","1559-0879"],"issn-type":[{"value":"1556-9845","type":"print"},{"value":"1559-0879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,18]]}}}