Establishing Care Post Discharge Following a Heart Failure Hospitalization in an Uninsured Heart Failure Population

Area of Science:

• Cardiology
• Health Services Research
• Health Disparities

Background:

• Multidisciplinary interprofessional outpatient care is proven to reduce mortality in heart failure (HF) patients.
• This crucial care is underutilized, particularly among uninsured populations.
• Identifying barriers to outpatient care access is essential for improving HF patient outcomes.

Purpose of the Study:

• To identify factors associated with failure to establish outpatient care among uninsured individuals with heart failure (HF) post-hospitalization.
• To understand disparities in accessing follow-up care within this demographic.

Main Methods:

• The study analyzed uninsured individuals hospitalized with HF from 2016-2019.
• Establishing care was defined as attending an interprofessional clinic within 7 days of discharge.
• Multivariable logistic regression models identified predictors of establishing care.

Main Results:

• Of 698 referred uninsured patients, 84% established care.
• Black, rural-dwelling participants had significantly lower odds of establishing care (aOR 0.07).
• Alcohol use also lowered odds for Black participants (aOR 0.32), while rural White participants had higher odds (aOR 2.63).

Conclusions:

• Uninsured Black individuals with HF residing in rural areas or reporting alcohol use are at high risk for not establishing outpatient follow-up.
• Significant disparities exist in accessing post-hospitalization care for HF patients.
• Interventions addressing these disparities are crucial to improve health outcomes in this high-risk population.