Abstract P333: Homelessness is an Independent Risk Factor for Cardiovascular Disease Hospital Readmission in the California Health Care Utilization Project
Introduction: Persons who experience homelessness have been shown to have a high prevalence of cardiovascular risk factors, and high incidence of cardiovascular mortality, however little is known about the outcomes of patients experiencing comorbid homelessness and recurrent CVD admissions. We sought to study the effects of homelessness on CVD readmission in California.
Methods: We identified all patients admitted with a primary diagnosis of CVD (including ischemic heart disease, stroke and heart failure) in the HCUP California database between 2005 and 2009. Homelessness was defined using an HCUP indicator variable. We used multivariable Cox proportional hazards model to determine risk of readmission for potential sociodemographic and clinical confounder variables (see Table).
Results: There were 2,889 hospital admissions for CVD in patients who were identified as homeless during the baseline period (by means of a homelessness indicator). Of those, there were 928 hospital readmissions (median time to readmission=39 days). When adjusted for clinical and lifestyle factors (see Table), homelessness independently predicted recurrent CVD [HR of 1.44 (95% CI, 1.36-1.52)].
Conclusions: In HCUP CA, homelessness independently predicted CVD readmission. Our findings suggest a potential need for development and study of interventions to improve post-hospital management of CVD in patients experiencing homelessness.
Author Disclosures: E.F. Shalen: None. G. Nah: None. E. Vittinghoff: None. Z.H. Tseng: None. G.M. Marcus: None. M.A. Albert: None. N.I. Parikh: None.
- © 2017 by American Heart Association, Inc.