Presentation (CTI)

OBJECTIVES: Health disparities arise from various socio-demographic factors and their interactions This study provides a cross-disease comparison of the impact of disparity in 5 critical diseases (CV, rare, and cancers) in Hospitalization outcomes: Sickle Cell Disease (SCD), Colorectal Cancer (CRC), Neuromyelitis Optica Spectrum Disorder (NMOSD), Heart Failure (HF), and Multiple Myeloma (MM).
METHODS: National Inpatient Sample (NIS) data from 2016 to 2020 was used for the analysis. The hospitalization outcomes included length of stay (LOS), total hospitalization charges (THC), and mortality rates. All analysis utilized a similar range of statistical analyses, including ANOVA, t-tests, and both univariate and multivariable regression models.
RESULTS: Hospitalizations analyzed were 20,907 for MM (2016-2020), 18,086 for SCD (2017), 1,686 for NMOSD (2016-2020), 191,484 for HF (2017), and 17,742 for CRC (2020). Black patients (MM: $135,377; NMOSD: $81,404; SCD: $33,964) had higher mean total charges in comparison to White (MM: $134,132; NMOSD: $80,089; SCD: $45,810) and Hispanic populations (MM: $168,685; NMOSD: $98,501; SCD: $45,81) for MM, NMOSD, and SCD. In contrast, Hispanic patients had higher total charges in comparison to the White and Black populations for HF and CRC. Male patients with Medicare had higher mean total charges with CRC. In the case of MM, Female patients, Black patients, and those with private insurance had higher mortality rates. Black and female patients face a higher rate of hospitalization due to NMOSD. Female patients with Medicare had longer LOS for SCD (5.5 days on average) and HF (5.3 days on average), however, Medicaid patients with NMOSD had a longer LOS compared to Medicare.
CONCLUSIONS: Patterns of disparity varied between the 5 diseases (cancer, rare, and cardiovascular) with some overlapping factors impacting outcomes. Being female and being Black were the most indicative factors for poor outcomes and higher costs.