Co-Occurrence of Social Risk Factors and Associated Outcomes in Patients With Heart Failure

Area of Science:

• Health Services Research
• Social Determinants of Health
• Cardiology

Background:

• Social risk factors (SRFs) are linked to adverse outcomes in heart failure (HF) patients.
• The impact of co-occurring SRFs on healthcare utilization in HF is not well understood.
• Novel methods are needed to classify and analyze combined SRFs.

Purpose of the Study:

• To investigate how co-occurring social risk factors affect healthcare utilization in heart failure patients.
• To utilize latent class analysis for classifying subgroups of SRFs.
• To examine the association between identified SRF subgroups and outcomes.

Main Methods:

• Cohort study of 3142 HF patients (≥18 years) in southeast Minnesota (2013-2017).
• SRFs assessed included education, health literacy, social isolation, race/ethnicity, area deprivation, and rural-urban codes.
• Andersen-Gill models and latent class analysis were used to assess associations between SRFs and healthcare utilization (ED visits, hospitalizations).

Main Results:

• Low education, high social isolation, and high area-deprivation index showed the strongest association with hospitalizations.
• Latent class analysis identified 4 distinct subgroups of SRFs.
• Patients in the subgroup with more SRFs (Group 3) had increased risk for emergency department visits (HR 1.33) and hospitalizations (HR 1.42).

Conclusions:

• Specific SRFs like low education, social isolation, and area deprivation are strongly associated with HF outcomes.
• Latent class analysis effectively identified meaningful subgroups of patients based on co-occurring SRFs.
• Understanding these SRF subgroups can improve prediction of healthcare utilization in HF management.