Saif S. Rathore|Frederick A. Masoudi|Yongfei Wang|Jeptha P. Curtis|JoAnne M. Foody|Edward P. Havranek|Harlan M. Krumholz
Socioeconomic status, treatment, and outcomes among elderly patients hospitalized with heart failure: Findings from the National Heart Failure Project
Yale University|Denver Health Medical Center|University of Colorado Denver|University of Colorado Health|Arkansas Foundation for Medical Care|Yale University|Yale University|Yale University|Arkansas Foundation for Medical Care|University of Colorado Health|Denver Health Medical Center|University of Colorado Denver|Yale New Haven Hospital|Yale University
prior studies reported conflicting findings concerning association socioeconomic status ses treatment outcomes patients hospitalized heart failure hfwe conducted retrospective analysis medical record data national sample medicare beneficiaries hospitalized hf march 1998 april 1999 n 25086 assess association patient ses treatment outcomes patients ses designated lower lowermiddle highermiddle higher using residential zip code characteristics patients evaluated left ventricular systolic function assessment prescription angiotensinconverting enzyme inhibitors discharge readmission within 1 year discharge mortality within 30 days 1 year admission hierarchical logistic regression models used assess association ses quality care outcomes adjusting patient physician hospital characteristicslower ses patients relative risk rr 092 95 ci 087096 modestly less likely left ventricular systolic function assessment similar adjusted likelihood prescribed angiotensinconverting enzyme inhibitors rr 103 95 ci 093111 compared higher ses patients multivariable adjustment socioeconomic status associated 30day mortality multivariable adjustment lower ses patients higher risk 1year mortality rr 110 95 ci 102119 readmission within 1 year discharge rr 108 95 ci 103112 compared higher ses patientssocioeconomic status patients hospitalized hf strongly associated quality care 30day mortality however increased risk 1year mortality readmission among patients lower ses suggest ses may influence outcomes hospitalization hf