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Abstract 223: Assessment Of The Impact Of Social And Racial Determinants On Patients Admitted With Heart Failure To A Safety Net Hospital


 Background:
 Heart failure (HF) plays a role in more than 10% of deaths annually in America. Due to high economic burden, hospital readmissions are used as a measure of outcome in HF patients. Readmission rates are influenced by many factors including coronary artery disease (CAD), chronic kidney disease (CKD), diabetes, race, and socioeconomic factors, as such as insurance and neighborhood median income. This study analyzes demographic characteristics and readmission rates at a teaching safety net hospital with a comprehensive HF program.
 
 
 Methods:
 A retrospective chart review of 200 consecutive HF patients admitted to our hospital from 2011 to 2020 was performed. Zip codes were correlated to social deprivation index (SDI) using data from the 2011-15 American Community Service, a project of the US Census Bureau. All 90-day readmissions due to cardiac related conditions were included. Descriptive studies are reported. χ
 2
 and Independent Samples T test were used to identify demographic features correlated with cardiac readmissions.
 
 
 Results:
 There was a total of 44 readmitted patients (22%). Mean age was 74.6 vs 71 .57 in not readmitted (NRA) vs readmitted (RA) (p=0.492), sex was 50% male in both groups (p=1.00). Mean EF was 41.1 % vs 47.81% (NRA vs RA, p=0.332). There was no difference in incidence of CAD (p=0.348), HTN (p=0.15), Afib (p=0.303), CKD (p=0.374), DM (p=0.361) in NRA vs RA groups. Patients with pre-existing HF and a primary language other than English trended towards more readmissions (85.6% vs 95.5% p=0.059 and 19.2% vs 31.8% p=0.061). There was no statistical difference in non-white race (46.8% vs 56.8% p=0.158), extreme social deprivation as measured by SDI >76 (22.4% vs 22.7% p=0.557), or insurance presence (64.1% vs 63.6% p=0.544) in NRA vs RA groups.
 
 
 Conclusion:
 Treatment of hospitalized HF patients at our safety net hospital is equitable among hospitalized patients regardless of patient comorbidities, demographics, and socioeconomic status. Further studies should focus on attributes of a comprehensive heart failure program that contribute to this high quality of care, so they can possibly be replicated at other hospitals to improve outcomes across all patient populations.
