Racial Disparities in PAD-Related Amputation Rates among Native Americans and non-Hispanic Whites: An HCUP Analysis

J Health Care Poor Underserved. 2018;29(2):782-800. doi: 10.1353/hpu.2018.0058.


Introduction: This study analyzed the impact of sociodemographic characteristics, patient comorbidities, risk factors for critical limb ischemia and hospital characteristics on racial disparities in amputation rates for Native American patients with peripheral artery disease (PAD).

Methods: The study used the Healthcare Cost and Utilization Program inpatient discharge data from 2006-2013 for patients with a primary diagnosis of PAD. Multivariable models using the Blinder-Oaxaca decomposition method were estimated to isolate the impact of individual covariates to identify determinants of amputation rates for Native Americans compared with non-Hispanic Whites.

Results: Region of the country made a difference in this analysis with Native Americans residing in the West Census Region being twice as likely to undergo amputation as non-Hispanic Whites.

Conclusions: After adjusting for sociodemographic characteristics, patient comorbidities, and hospital characteristics, Native Americans with PAD who reside in the West Census Region are substantially more likely to undergo amputation than are non-Hispanic Whites.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amputation, Surgical / statistics & numerical data*
  • Databases, Factual
  • Female
  • Healthcare Disparities / ethnology*
  • Humans
  • Indians, North American / statistics & numerical data*
  • Male
  • Middle Aged
  • Peripheral Arterial Disease / complications
  • Peripheral Arterial Disease / ethnology*
  • Residence Characteristics / statistics & numerical data
  • Retrospective Studies
  • United States
  • White People / statistics & numerical data*