Insurance and Structural Access Quality and Effects on AAA Mortality: A National Healthcare Quality and Disparities Report Analysis.

Background: The National Health care Quality and Disparities Report (NHDQR) presents trends for measures related to access to care, affordable care, care coordination, effective treatment, healthy living, patient safety, and person-centered care. This study aims to determine the significance of insurance quality and access to care on AAA repair outcomes.

Methods: Data was obtained through the Agency for Health care Research and Quality database from 2016-2020. AAA repair mortality rates per 1000 persons, insurance quality, and structural access were compared between the 31 reportable U.S. states in which data was analyzed using linear regression models and ANOVA. Insurance quality and structural access groups were categorized as weak, average, and strong, based on NHDQR Reports measures.

Results: No association was found between access to care and AAA mortality at specific time points (2016 and 2020; P-value = .90 and .29 respectively) and when comparing states that showed improvement from 2016 to 2020 (weak categorization to strong; P value = .27). An association was found between private insurance quality and AAA repair mortality at baseline (2016; P-value = .022) and in those that showed improvement or worsening in private insurance quality over the study period (P-value = .042).

Conclusions: Our findings suggest that there is no association between structural access quality and AAA mortality although an association exists between AAA mortality and private insurance quality.