Abstract 15542: Social Determinants of Health Screening of Patients With Congestive Heart Failure Within Multiple Urban Ambulatory Clinics

Abstract

Introduction: There is a growing body of literature dedicated to understanding the implications of social determinants of health (SDOH) on cardiovascular disease. This study evaluated a pilot of standardized SDOH screening questionnaires in two large urban ambulatory clinics within a quaternary integrated health network in the Northeastern United States. Goals/Aims: This study aims to investigate common social determinants of health which may influence patients with congestive heart failure (CHF). Methods: A retrospective review of the incidence of SDOH in adult patients from two Internal Medicine outpatient residency clinics between 2020 and 2023 was performed. SDOH assessment was performed at every visit. Multivariate logistic regression analysis was performed to assess the association of SDOH in patients with and without CHF. Results: A total of 14,516 patients were evaluated during this study period (mean age 66 years, 62% female). When matched for age and sex, 808 patients with CHF were compared to those without CHF. In matched data, those with CHF were significantly less likely to endorse food insecurity (64.2% vs 94.6%, p<0.05), lack of safety (1.4% vs 2.8%, p<0.05), lack of social connection (34.4% vs 86.8%, p<0.05), and stress (29.1% vs 84.3%, p<0.05). Patients with CHF were more likely (91% vs 26%, p<0.05) to report a positive PHQ-9 depression screen [Table 1]. Patients with CHF were also noted to have a higher incidence of comorbid illnesses. Conclusions: Utilization of evidence-based SDOH screening questions in the workflow can help identify key barriers to cardiovascular diseases such as CHF. Multidisciplinary care in patients with CHF may contribute to improved SDOH reporting. Future studies should use qualitative and quantitative data in combination to further evaluate and address barriers to care in patients with CHF.