Peripheral Arterial Disease Burden and Treatment Costs Among Diabetic Adults in Texas Border Regions

Background Individuals with diabetes are at increased risk for peripheral arterial disease (PAD), a marker for coronary and cerebrovascular disease that increases the risk of heart attack and stroke. Racial and ethnic minority groups face a disproportionately high burden of PAD. However, the role of geographic location remains poorly understood. This study examines differences in diabetes-related PAD patterns and healthcare costs between border and nonborder regions in Texas. Methods Using a 10% random sample of 2021–2022 Texas Inpatient Hospital Discharge Data, we identified 224,755 diabetes-related discharges on the basis of ICD-10 codes, of which 37,448 (16.7%) also included a diagnosis of PAD. Logistic and linear regression analyses were performed on a balanced dataset (n = 74,896) with equal numbers of diabetes patients with and without PAD. Cost analyses evaluated differences in diabetes-related PAD billed treatment charges between border and nonborder regions. Results Border regions had significantly higher proportions of Hispanic individuals and residents from HPSA-designated areas. Border patients incurred consistently higher mean charges across all racial/ethnic groups. In the adjusted models, female sex, rural residence, and health professional shortage area designation were associated with lower odds of PAD, whereas Hispanic ethnicity, Medicare coverage, border residence, and older age, particularly 60–64 years, were associated with higher odds of PAD. In the linear regression, PAD diagnosis and border residence were significant predictors of increased total charges. Conclusion Elevated costs and disease burdens in border regions, especially among Hispanic populations, highlight the need for targeted healthcare strategies, early diagnosis, and treatment to improve PAD outcomes.