Introduction:
Neighborhood factors such as walkability and proximity to stores, parks, and public transportation have been associated with obesity, diabetes, and physical activity level as well as hospital readmission rates. Among individuals with systolic heart failure (HF), reducing hospital readmissions is challenging, but little is known on the role of neighborhood factors on hospital readmissions in this population.
Hypothesis:
We hypothesized that better walk scores and less deprivation would be associated with a lower readmissions in HF patients.
Methods:
We screened hospitalized patients with systolic HF (EF≤45%) and NYHA class II-IV symptoms for depression at 8 Pittsburgh-area hospitals as part of the Hopeful Heart Study (R01 HL114016) and included patients who screened positive for depression and remained depressed when re-contacted by telephone 2 weeks after discharge. We classified neighborhoods using the validated neighborhood Walk Score®and Area Deprivation Index for each patient’s address at study entry (both 0-100 scales), and assessed readmissions for 12 months following each patient’s enrollment. We then compared the ADI and Walk Score of individuals who were readmitted vs. those who were not.
Results:
Final analysis included 629 depressed patients with systolic HF (43% female, 75% white, 86% HTN, 52% DM). Overall, 73.1% of individuals were readmitted at least once, and readmitted and not readmitted patients had similar walk scores (34.1±25.2 vs. 32.2±27.0, p = 0.40) and ADI (66.6±23.1 vs. 64.2±22.7, p=0.50) as those who were not readmitted. Table 1.
Conclusions:
Among depressed patients with systolic HF, Walk Score and ADI were associated with not associated with readmission rates. Further research is warranted to determine how neighborhood factors adversely impact individual with co-morbid depression and systolic HF. Further analyses are ongoing to determine if individual components of the Walk Score and ADI contribute to differences in readmission.
The Impact of a Dedicated Heart Failure (HF) Clinic on Hospitalization Rates, Hospitalization Costs, and Left Ventricular Ejection Fraction (LVEF) in Systolic Heart Failure Patients
