Abstract 10855: Impact of Race/Ethnicity, Sex, and Socio-Economic Status on the Risk for Heart Failure Readmission: The Importance of Context
Background: Though Hispanics (H) have higher heart failure (HF)-related readmission rates compared to non-Hispanics (NH), their in-hospital mortality is reported as lower. Social determinants of health (e.g. educational attainment, annual income and geographic location) are associated with health outcomes regardless of ethnicity. The state of New Mexico has a large Hispanic community accounting for 47% of the population and is one of the poorest states in the country with low literacy levels. These factors make New Mexico a unique venue to assess health outcomes and the impact of ethnicity, sex, and social factors.
Methods: We analyzed data from 1608 consecutive patients discharged from the University of New Mexico Hospital between 2010-2014 with a principle diagnosis of heart failure. We explored the associations between race/ethnicity, age, sex, level of poverty, education level, and distance from hospital and risk for 30 day readmission using univariable and multivariable statistical analysis.
Results: Mean age on admission was 63.0 ± 14.1. Men represented 58.4% and 48.8% of the sample population were H. The overall 30 day readmission rate (30dRR) was 13.4%. 30dRR for H was 17.5% compared to 9.6% of NH (p>0.00); for females, regardless of race/ethnicity, 30dRR was 16.7% compared to 10.9% for males (p=0.001). All selected socioeconomic variables were significantly associated with 30dRR on univariable analysis. However, on multivariable analysis only H ethnicity, sex, poverty level and distance from hospital were associated with readmission. Poverty level was strongly associated with higher 30dRR (OR 2.8; 95% CI 1.58-5.19; p>0.001). Living furthest from hospital was associated with lower readmission rate (OR 0.5; 95% CI 0.3-0.8; p>0.007). The rates of clinical characteristics (e.g., diabetes, hypertension, etc.) were similar between groups and did not associate with 30dRR.
Conclusion: In this unique, less ethnically and socio-economically diverse environment where poverty rates are high and education attainment is low, Hispanic ethnicity, female sex, and living in poverty is associated with higher risk for 30dRR in patients with HF.
Author Disclosures: S. Ponce: None. D. Dodendorf: None. D. Butler: None. M. Martinez: None. B. Cox: None. W. Laskey: None.
- © 2015 by American Heart Association, Inc.