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Socioeconomic disadvantage and days at home after hospital discharge of patients with heart failure


Huynh, Q and Venn, AJ and Marwick, TH, Socioeconomic disadvantage and days at home after hospital discharge of patients with heart failure, American Journal of Cardiology, 122, (4) pp. 616-624. ISSN 0002-9149 (2018) [Refereed Article]

Copyright Statement

Copyright 2018 Elsevier Inc.

DOI: doi:10.1016/j.amjcard.2018.04.051


The risk of heart failure (HF) readmission may be reduced by disease management programs, but the resource-intensive nature of these requires targeting to the greatest need. As socioeconomic status (SES) is related to other health outcomes, we sought whether regional markers of SES were associated with days at home (alive and out of hospital) after discharge. This study used statewide data of 1,391 HF patients who had their first ever HF admission to a public hospital in Tasmania (Australia) during 2009 to 2012. Measurements of residential SES included four indexes and a remoteness index generated by the Australian Bureau of Statistics. The primary outcome was days at home. Secondary outcomes included 30- and 90-day readmission or death, number of readmissions, and days to first readmission. Our HF patients had a median of 352days at home [interquartile range 167, 361]. All four SES indexes and the remoteness index (p <0.001) were adversely associated with days at home, independent of other clinical and nonclinical factors. Findings for readmission at 30 and 90days of discharge were inconsistent; the index of Relative Socioeconomic Advantage and Disadvantage (but not other SES indexes) was independently associated with 30-day readmission (odds ratio 1.58, p = 0.008) and remoteness index was significantly associated with 90-day readmission (odds ratio = 1.99, p = 0.009). Analyzing days to first readmission did not show any significant differences among categories of SES (log-rank test p = 0.81) or remoteness index (log-rank test p = 0.47). Thus, residential SES is associated with adverse outcome in HF, and might be useful in planning services to reduce HF readmission.

Item Details

Item Type:Refereed Article
Keywords:heart failure, socioeconomic status, hospital discharge, patient readmission
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Huynh, Q (Dr Quan Huynh)
UTAS Author:Venn, AJ (Professor Alison Venn)
UTAS Author:Marwick, TH (Professor Tom Marwick)
ID Code:128171
Year Published:2018
Web of Science® Times Cited:3
Deposited By:Menzies Institute for Medical Research
Deposited On:2018-09-06
Last Modified:2022-08-25

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