Readmissions Among Patients Admitted With Acute Decompensated Heart Failure Based on Income Quartiles.

Publication/Presentation Date

10-1-2019

Abstract

OBJECTIVE: To determine the impact of socioeconomic status using median household income within the patient's community on rate of readmission among patients with heart failure (HF).

PATIENTS AND METHODS: We derived a study cohort of patients who were admitted from January 1, 2013, through December 31, 2014, with congestive HF from the Healthcare Cost and Utilization Project National Readmission Database. Patients were stratified into quartiles according to the estimated median household income of residents in the patient's ZIP Code (quartile 1, lowest; quartile 4, highest). The primary outcome was 30-day readmission. We used univariate and multivariate models to compare patients with respect to baseline characteristics, income quartiles, and 30-day readmission.

RESULTS: About 20% (110,152 of 546,841) of patients with an index HF admission were readmitted within the first 30 days. Patients in the lowest income quartile had a higher readmission rate compared with those in the highest income quartile (21.1% [35,422 of 167,625] vs 19.5% [20,771 of 106,353]; P

CONCLUSION: Our study shows that patients in communities with the lowest quartile of income have a higher rate of readmission following the index HF admission with high associated costs. Readmission reporting and reimbursement adjustments should account for these socioeconomic inequalities.

Volume

94

Issue

10

First Page

1939

Last Page

1950

ISSN

1942-5546

Disciplines

Medicine and Health Sciences

PubMedID

31585578

Department(s)

Fellows and Residents

Document Type

Article

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