Abstract 15725: Access to Pacemaker Implantation Amongst Medicare Beneficiaries: Travel Distance and Time to Nearest Clinician

• DOI: 10.1161/circ.148.suppl_1.15725
• Publication Date: 2023-12-19T08:08:02Z
• Authors: Pegah Khaloo; Kevin Wheelock; Sohum Kapadia; Rohan Khera
• Keywords: Single Center; Zip code

Background: Despite being an essential procedure with rising use in the United States, availability and accessibility of procedural care for a permanent pacemaker are not known. We investigated access to implantation among Medicare beneficiaries. Methods: US physician claims from 2020, county population characteristic data AHRQ were used evaluate density providers beneficiaries across states counties. For each zip code, we determined closest center using haversine formula, then assessed travel duration route Google Maps API. Results: There was median 5 performing placement per 100,000 individuals over 65 years all states, IQR 4.5 6. At level, only 20% counties had offering transvenous implantation, 4% leadless pacemakers. Individuals metropolitan drove 29 (IQR 18 - 47) minutes reach while those non-metropolitan 72 52 102) minutes. In where >25% is ≥65 old, drive time 86 57 126) Residents lower household income (Spearman’s r = 0.45, p < 0.001) higher percentage residents public insurance longer (r 0.23, 0.001). Out estimated 55,356,000 old 20,000,000 (36%) more than one hour, 4,383,955 (8%) two hours site performed. Conclusion: Over one-third States has significant issues basic electrophysiologic care, highlighting need increased resources improved accessibility.