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Socioeconomic, Psychosocial and Behavioral Characteristics of Patients Hospitalized With Cardiovascular Disease
Matthew E Dupre1, Alicia Nelson2, Scott M Lynch3
1Duke Clinical Research Institute, Duke University, Durham, North Carolina; Department of Population Health Sciences, Duke University, Durham, North Carolina; Department of Sociology, Duke University, Durham, North Carolina.
Insights
Cardiovascular disease patients show diverse nonclinical traits, including socioeconomic and psychosocial factors. Understanding these characteristics is key to personalizing care and improving outcomes for vulnerable individuals.
Area of Science:
- Cardiology
- Health Services Research
- Health Disparities
Background:
- Growing recognition of nonclinical factors influencing cardiovascular disease (CVD) disparities.
- Limited research on nonclinical characteristics of hospitalized CVD patients.
Purpose of the Study:
- To describe the nonclinical profiles of patients hospitalized for cardiovascular care.
- To identify associations between nonclinical characteristics and patient demographics.
Main Methods:
- Utilized electronic medical records and pre-discharge surveys from 520 Duke Heart Center patients (2015-2017).
- Collected data on demographic, socioeconomic, psychosocial, and behavioral attributes.
- Analyzed heterogeneity and associations among nonclinical factors.
Main Results:
- Median age 65, 61.4% male, 67.1% non-Hispanic white; hospitalization averaged 5.11 days.
- Significant heterogeneity observed in demographic, socioeconomic, and behavioral characteristics.
- Psychosocial risks/resources associated with nonclinical factors; older, female, nonwhite, unmarried patients had poorer psychosocial profiles.
Conclusions:
- Hospitalized cardiovascular patients exhibit diverse nonclinical profiles.
- These characteristics impact intervention targeting and personalized care delivery.
- Improved understanding can enhance outcomes for vulnerable patient groups.
Background:
Recent studies have drawn attention to nonclinical factors to better understand disparities in the development, treatment and prognosis of patients with cardiovascular disease. However, there has been limited research describing the nonclinical characteristics of patients hospitalized for cardiovascular care.
Methods:
Data for this study come from 520 patients admitted to the Duke Heart Center from January 1, 2015 through January 10, 2017. Electronic medical records and a standardized survey administered before discharge were used to ascertain detailed information on patients' demographic (age, sex, race, marital status and living arrangement), socioeconomic (education, employment and health insurance), psychosocial (health literacy, health self-efficacy, social support, stress and depressive symptoms) and behavioral (smoking, drinking and medication adherence) attributes.
Results:
Study participants were of a median age of 65 years, predominantly male (61.4%), non-Hispanic white (67.1%), hospitalized for 5.11 days and comparable to all patients admitted during this period. Results from the survey showed significant heterogeneity among patients in their demographic, socioeconomic and behavioral characteristics. We also found that the patients' levels of psychosocial risks and resources were significantly associated with many of these nonclinical characteristics. Patients who were older, women, nonwhite and unmarried had generally lower levels of health literacy, self-efficacy and social support, and higher levels of stress and depressive symptoms than their counterparts.
Conclusions:
Patients hospitalized with cardiovascular disease have diverse nonclinical profiles that have important implications for targeting interventions. A better understanding of these characteristics will enhance the personalized delivery of care and improve outcomes in vulnerable patient groups.
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