Abstract 16279: Impact of Race and Socioeconomic Status on Rates of Congestive Heart Failure Admissions, Readmissions, and Length of Stay

Abstract

Introduction: Health disparities due to race and socioeconomic status persist among congestive heart failure (CHF) patients. Our hospital in the Philadelphia area is uniquely situated to study disparities as it sits on the border of a diverse inner city and suburban population. The area west of our hospital is known to have a drastically higher median income than the area to the east. We aimed to evaluate differences in rates of CHF admissions, readmissions, and length of stay (LOS) for patients based on race and socioeconomic status. Methods: From 3/1/2018 to 3/31/2020, 6,785 total patients were admitted to our hospital due to acute decompensated CHF. To compare rates of admission, readmission and a LOS > 5 days based on race and socioeconomic status, we used the SlicerDicer function of the EPIC electronic record platform. For race, we compared data for white and black patients. For socioeconomic status, we included a 10-mile radius around our hospital and used public records to collect median household income for 11 zip codes to the east and 11 to the west. The average yearly median household income for the east and west zip codes were USD $27,171 and $134,390, respectively. Outcomes are expressed as percentages and compared using a Chi-square test of independence and 95% confidence interval (CI) for differences. Significance was assessed at the 0.05 level. Results: Admission rates were significantly higher among Black patients at 67% compared to White patients at 58% (95% CI 7-11%, p<0.05). There was no significant difference between rates of readmission (60% for Black vs. 58% for White patients, 95% CI 0-4%, p=0.11) or LOS > 5 days (56% for Black vs. 55% for White patients, 95% CI 0-3%, p=0.42). Admission rates were significantly higher among patients from low income areas at 70% compared to high income areas at 56% (95% CI 11-17%, p<0.05). Readmission rates were not significantly different, 57% for low income and 56% for high income areas (95% CI 0-4%, p=0.82). Patients from low income areas were significantly more likely to have a LOS > 5 days at 57% compared to patients from high income areas at 53% (95% CI 0.8-8%, p<0.05). Conclusions: Race and socioeconomic status continue to impact CHF patients’ health outcomes including rates of admissions, readmissions, and length of stay.