Abstract 4145173: Neighborhood Socioeconomic Deprivation is Associated with Mortality and Readmission for Common Cardiovascular Conditions: a Nationwide Cohort Study of >2 Million Patients

Understanding the relationship between neighborhood socioeconomic environment and cardiovascular outcomes is important to implement effective quality strategies to ensure health equity. To determine the association of neighborhood socioeconomic deprivation with 30-day mortality and readmission for patients admitted with common cardiovascular conditions. We examined claims data from fee-for-service Medicare beneficiaries aged >=65 with 1 year of preceding fee-for-service eligibility between 2017-2019 admitted for heart failure, valvular heart disease, ischemic heart disease, or cardiac arrhythmias. The primary exposure was the Area Deprivation Index, and outcomes were 30-day all-cause mortality and unplanned readmission. We used logistic regression models and adjusted for demographics, medical comorbidity burden, access to healthcare resources, and characteristics of admitting hospitals. A total of 2,064,426 admissions were included. Patients from socioeconomically deprived neighborhoods generally had higher observed mortality and readmission (Table 1). After full adjustment, neighborhood socioeconomic status was associated with increased 30-day mortality and readmission for all cardiovascular conditions studied. Unadjusted and sequentially adjusted models for 30-day mortality are shown in Table 2. Figure 1 visualizes the adjusted association between neighborhood deprivation and 30-day mortality and readmission. Neighborhood socioeconomic deprivation was independently associated with increased 30-day mortality and readmission for several common cardiovascular conditions.

Duke Scholars

Author Robert John Mentz Medicine, Cardiology