Abstract 2381: Socioeconomic Status is Associated with Increased Morbidity in Patients Enrolled in a Dedicated Heart Failure Program
Despite continued advances in medicine, the NIH has reported that differences in the incidence, prevalence, and burden of diseases persist between socioeconomic classes. Heart failure (HF) is the leading cause of hospitalizations in all patients over the age of 65. The effect of socioeconomic disparities on this major cause of morbidity has not been well studied. A retrospective analysis was performed on 500 patients with heart failure followed in the University of Illinois-Chicago heart failure clinic from 1/1/2000 –1/1/2008. Patients were stratified by household income and education level by correlating patient zip codes with the 2000 U.S. Census Data. The primary endpoint was admission for HF exacerbation. In patients with established HF, patients living in areas with lower median household incomes were significantly more likely to have a HF exacerbation (P = 0.006), as well as an increase in total exacerbations (P = 0.005) through an average follow up period of 5.2 years. The same trend was observed when areas were stratified according to the percentage of population with bachelor’s degrees. Overall, baseline characteristics were similar between groups. Significant differences by household income and education level were found in hypertension, presence of coronary artery disease and medication use (Tables 1⇓ and 2⇓). Despite uniform treatment according to ACC/AHA guidelines, socioeconomic disparities were associated with increased morbidity in patients established in a dedicated heart failure program. Further studies are needed to address these disparities.