Recipients of Public Insurance Have Increased Mortality Post-LVAD

PURPOSE: LVADs have revolutionized the care of end-stage heart failure patients. Utilizing block-group census data to characterize neighborhood-level socioeconomic status(nSES), we set out to examine the effect of nSES & public versus private insurance status with respect to overall mortality and readmission. METHODS: We performed a retrospective review of LVAD recipients bet. Jun 2006 & Dec 2016 at the Ohio State University Wexner Medical Center (n=239). Primary outcomes were time to death and time to readmission. RESULTS: Patients' demographics are shown in Table 1. Patients on public insurance displayed a higher hazard of death post-LVAD compared to private insureds (Fig. 1; log-rank p=0.0004). Medicaid, Medicare, and Medicaid-Medicare dual-enrollment were significant independent predictors of death, with an associated ≥3 fold hazard of death. TR of varying severity was also a significant independent predictor of mortality (Table 2). Median household income (MHI) was not associated with any primary outcomes. CONCLUSION: LVAD recipients on public insurance were at higher mortality risk compared to private insureds. Block-group level MHI failed to predict mortality and 1 year readmission for these patients. More work is needed to properly contextualize the SES impact on LVAD outcomes.