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Readmissions among patients admitted with acute decompensated heart failure based on income quartiles

Mayo Clinic Proceedings Oct 07, 2019

Patil S, et al. - Through a study cohort of individuals (n = 546,841) who were admitted from January 1, 2013, through December 31, 2014, with congestive heart failure (HF) from the Healthcare Cost and Utilization Project National Readmission Database, researchers ascertained the influence of socioeconomic status using median household income within the patient's community on rate of readmission among patients with HF. About 20% (n = 110,152) of individuals with an index HF admission were admitted again within the first 30 days. In comparison with those in the highest income quartile, individuals in the lowest income quartile had a greater readmission rate. Greater odds of readmission for cardiovascular causes were noted in individuals within the lowest income group vs the highest income group. Within the lowest income group, readmissions estimated for 30% of all rehospitalization-related costs at $715 million. A greater rate of 30-day readmission, as validated by multivariate analysis, was observed among individuals in the lowest income group vs the highest group. Hence, this study reveals a greater rate of readmission after the index HF admission in patients in communities with the lowest quartile of income and with high associated costs. Moreover, readmission recording and compensation adjustments should reckon for these socioeconomic inequalities.
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