Abstract 109: Impact of Socio-Economic Factors on Health Care Visits Among Patients with Heart Failure

Abstract

Background: Ambulatory health care visits (HCVs) have substantial impact on heart failure (HF) outcomes. We tested the hypothesis that the number of HCVs vary by race, insurance status and other socioeconomic status (SES) factors among both hospitalized and non-hospitalized HF patients. Methods: Using the United States NHANES 2005-2016 database, 1154 individuals with HF were identified based on reported diagnosis. Multivariate logistic regression using the proportional odds model was performed with number of HCVs in 12 months as the dependent variable. Age, race, sex, educational status, income and insurance status were the independent variables. Survey procedures that account for the weighted, clustered sampling design, and non-response were used in the analysis. Results: Mean age of the sample was 67 years; including 51% females. Non-Hispanic whites, non-Hispanic blacks, and Hispanics accounted for 70 %, 16%, and 5% of the population, respectively. Multivariate analysis revealed that patients with insurance had a 2.5 greater odds of having more HCV compared to uninsured patients (OR 2.49,1.34-4.63 P=0.0042). There were no differences in women compared to men(OR 1.13, 0.84-1.51 P=0.42), Non-Hispanic whites compared to Hispanics (OR 1.183, 0.701-1.996 P=0.26), or people without a high school degree compared to those with a degree,(OR 1.343, 0.873-2.067 P=0.2815). Conclusions: Current analysis suggests an association between insurance status and number of HCVs. Unlike previous reports that considered hospitalized patients alone, the current analysis does not reveal significant racial or gender disparities.