Table 3

Comparison of studies on disparities in PAD treatment and outcomes

StudyPopulation characteristicsData sourceExposure with disparity assessed SES measureSES measurePertinent findings
Current studyN=21 673
United States
VQI registry data and Medicare claims dataMedicare–Medicaid dual-eligible patientsMedicare–Medicaid dual-eligibility statusThe delay in insurance for dual-eligible patients with PAD and subsequent delay in intervention cause worse postoperative outcomes when the patient presents with severe disease at the time of surgery.
O’Donnell et al26N=90 418
USA and Canada
VQI registry dataRaceInsurance status (Medicaid or self-insured vs other)Racial disparities in outcomes, regional variation in preoperative treatments but not postoperative
Arya et al13N=155 647
Veterans Affairs Corporate Data WarehouseRace and SES
  1. Median household income in residential zip code.

  2. Neighbourhood poverty level.

  3. Area Deprivation Index.

Low SES increases the risk of amputation. This finding suggests a role for early diagnosis and aggressive management of PAD in black patients.
Leifheit et al10N=505 955Medicare claims dataMedicare–Medicaid dual-eligible patientsMedicare–Medicaid dual-eligibility statusDual-eligible patients had higher rates of hospitalisation and 1 year mortality than Medicare only patients with PAD.
McDermott et al27N=1162
USA (Chicago only)
WALCS, WALCS II, WALCS III and Biomarker Risk Assessment in Vulnerable Outpatients StudyRace, SES and education level.
  1. Education level.

  2. Median household income in residential zip code.

Black patients with PAD have higher rates of mobility loss and becoming unable to walk for 6 min continuously. These differences appear related to racial differences in SES.
Roumia et al28N=1275
USA, Netherlands and Australia
Patient-Centred Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating TrajectoriesSex
  1. Insurance status.

  2. Delayed care due to cost.

As compared with men, women more often lacked health insurance and avoided care due to cost. Women had poorer PAD-specific functioning as compared with men, impacting all major health status domains, independent of socioeconomic and clinical characteristics.
Vart et al25N=12 517
USA (Midwest and Southeast)
Atherosclerosis Risk in Communities StudySES, Area Deprivation Index (ADI)
  1. Annual household income

  2. Educational attainment.

  3. Area Deprivation Index.

Incomes under $25K, education attainment less than high school and being in the highest quintile of the ADI are associated with higher rates of hospitalisation due to PAD.
  • ADI, Area Deprevation Index; PAD, peripheral artery disease; SES, socioeconomic status; VQI, Vascular Quality Initiative; WALCS, Walking and Leg Circulation Study.