Left ventricular assist device utilization across the different regions of the Netherlands

Abstract

Introduction: The accessibility of left ventricular assist device (LVAD) therapy is a crucial factor in the survival and quality of life of patients suffering from advanced heart failure. However, there is a lack of clarity regarding the utilization of this therapy across regions in the Netherlands as well as whether any disparities exist based on socioeconomic status (SES). This study aimed to determine the utilization of LVAD therapy at a regional level using administrative data and to identify potential disparities based on SES by comparing postal code data to demographic governmental data. Methods: All patients aged 16 or older who underwent a primary LVAD implantation between 2015 and 2024 were included. The data was visualized with a heatmap using Python. Results: A total of 710 patients received an LVAD during the study period. LVAD utilization was lower in the southernmost regions compared to the northernmost regions and varied in the central regions. An ANOVA test between SES groups did not show significant differences in LVAD utilization (p = 0.20). Conclusion: The findings of this study indicate that there are notable variations in the utilization of LVAD therapy across different geographical regions in the Netherlands. Nevertheless, no differences in LVAD use were found between areas with different SES categories. Future research should focus on identifying the underlying factors associated with referral for advanced heart failure therapies to ensure equitable access to LVAD therapy.