Is There a Relationship Between Neighborhood and HF Readmissions?

Previous research has linked neighborhood characteristics, such as low neighborhood socioeconomic status (SES) with lower adherence to therapy, worse quality of care, and worse outcomes among patients with heart failure. A study published July 29 in Circulation: Cardiovascular Quality and Outcomes, expanded on this research, and found that a patient’s neighborhood characteristics may be associated with readmissions for heart failure.

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The study was led by Behnood Bikdeli, MD, of the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT, and included data from 1,557 patients (mean age 61; 42 percent women) from 33 U.S. internal medicine and cardiology practices across the country. Their neighborhoods varied from low- to medium- to high-SES levels and the patients represented a variety occupations, income and educational background. Over the course of the 6-month study, researchers interviewed the subjects, tracked their medical visits, and looked at other factors like satisfaction of care and quality of life.

Overall, 745 patients (48 percent) had one or more hospital readmission and 179 patients (12 percent) died. The authors found that those living in low-SES neighborhoods were more likely to be readmitted than those who lived in high-SES areas. These results were the same even when variables such as the patient’s individual socioeconomic status were altered. However, the authors did not find an immediate correlation between neighbor socioeconomic status and mortality of heart failure patients, and after six months, the number of deaths across high- and low-SES areas were not significantly different.

Moving forward, the authors conclude that there is more to be learned from a lengthier study and further analysis that could answer questions about what the specific short- and long-term health effects and disease outcomes are depending on a person’s neighborhood. Pinpointing these effects will help close the gap in particular neighborhood-level disparities and attempt to improve health outcomes across the board.

Clinical Topics: Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: Outcome Assessment (Health Care), Patient Readmission, Quality of Life, Cardiology, Heart Failure, Income, Personal Satisfaction, Occupations, Residence Characteristics, Social Class

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