Patient-Reported Social Determinants of Health in Patients With Heart Failure

Area of Science:

• Cardiology
• Public Health
• Health Services Research

Background:

• Social determinants of health (SDOH) significantly impact medical care and patient outcomes.
• A lack of structured tools for assessing SDOH in clinical settings hinders research and patient care.
• This study addresses the need for a reliable instrument to evaluate SDOH in patients with heart failure.

Purpose of the Study:

• To assess the reliability and validity of a newly developed Social Determinants of Health (SDOH) Patient Interview Form.
• To investigate the prevalence and patterns of SDOH in patients diagnosed with heart failure.

Main Methods:

• The SDOH Patient Interview Form was administered to 367 recently hospitalized heart failure patients.
• Interviews were recorded, with 50 randomly selected for interrater reliability analysis.
• Data were analyzed to determine the reliability of the form and associations between SDOH and clinical factors.

Main Results:

• The SDOH Patient Interview Form demonstrated high interrater reliability (100% for categories, κ ≥0.94 for items).
• Higher SDOH burden correlated with younger age, lower income, increased New York Heart Association class, and higher BMI.
• Two primary SDOH patterns emerged: childhood abuse leading to adult deprivation, and stress from losses, financial strain, and caregiving difficulties.

Conclusions:

• The SDOH Patient Interview Form is a reliable tool for assessing patient-reported SDOH in heart failure populations.
• The instrument is suitable for both clinical and research applications, with potential for broader use in other patient groups.
• The study identified distinct, impactful patterns of social determinants contributing to patient health burdens.