Examining Heart Failure Outcomes Amid Housing Insecurity

Area of Science:

• Cardiology
• Public Health
• Health Services Research

Background:

• Housing insecurity is an understudied factor impacting heart failure (HF) patient outcomes.
• It is known to increase risks for communicable and noncommunicable diseases, potentially worsening HF prognosis and rehospitalization rates.

Purpose of the Study:

• To evaluate the impact of housing insecurity on heart failure (HF) outcomes and hospital utilization in the United States.
• To compare demographic characteristics and comorbidities between HF patients with and without housing insecurity.

Main Methods:

• Analysis of 2020 National Inpatient Sample and Nationwide Readmissions Database data for HF hospitalizations.
• Identification of housing insecurity using ICD-10 codes.
• Logistic regression and Cox proportional hazards models to assess mortality and readmission risks.

Main Results:

• 1.6% of 1,003,270 HF hospitalizations involved patients with housing insecurity.
• Patients with housing insecurity were younger, more likely to be Black or Hispanic, and had higher rates of alcohol/substance use disorders and Medicaid insurance.
• Housing insecurity was associated with lower in-hospital mortality but a higher risk of 180-day all-cause readmissions.

Conclusions:

• Patients with HF and housing insecurity exhibit distinct demographic profiles and comorbidities.
• They are more prone to readmission following hospitalization compared to their non-homeless counterparts.
• Targeted interventions addressing comorbid conditions in this population are crucial for reducing morbidity, mortality, and readmissions.