Late Breaking Original Research
Tuesday, October 15, 2024
08:30 AM–10:00 AM
Abstract
Introduction:
Social determinants of health (SDOH) are fundamental drivers of chronic disease development and exacerbation. In 2022, Congestive Heart Failure (CHF) accounted for 13.9% of all-cause deaths and cost approximately $30.7 billion. Readmissions significantly contribute to costs, as 20-25% of CHF patients are readmitted within 30 days of discharge. CHF is among the conditions targeted by the Centers for Medicare and Medicaid Services’ (CMS) Hospital Readmissions Reduction Program. CMS also requires inpatient SDOH screenings and referrals. Pharmacists are uniquely positioned and equipped to address SDOH, yet SDOH assessment within pharmacy practice remains limited. This study examined the social determinants of CHF readmissions within a multidisciplinary research partnership initiated by a pharmacist, public health scientist, and Quality and Risk Management team.
Research Question or Hypothesis:
What are the impacts of SDOH on 30-day CHF readmissions?
Study Design:
This study utilized a participatory research approach and retrospective design.
Methods:
This study analyzed an EPIC™-generated limited dataset with CHF hospitalizations between January 2021 and April 2024 at three Indiana urban hospitals. The primary outcome was 30-day readmission for CHF. Independent variables included SDOH, demographics, health behaviors, and health outcomes. Statistical analysis comprised descriptive, bivariate (Chi-Square), and multivariate (Binary Logistic Regression) analyses (p<0.05) in SPSS 29.0. This study was exempted by the Indiana University Human Research Protection Program (IRB #14040).
Results:
The sample comprised 5,489 patients with CHF, predominantly White (63.8%), 65+ years old (76.2%), and publicly insured (91.8%). The 30-day readmission rate was 22.4%. Bivariate analysis revealed significant (p<0.05) associations between 30-day readmissions and ethnicity, sex, language, hospital, insurance type, food insecurity, and depression risk. Food insecurity remained significant (OR=2.128; p=0.033) in multivariate analysis.
Conclusion:
Food insecurity was a significant predictor of 30-day readmission. Pharmacists can contribute to SDOH screenings, data analysis, and interventions. Future research should evaluate pharmacist-driven SDOH initiatives in various practice settings.
Presenting Author
Jonathan Guerrero PharmD, MSEdIndiana University School of Medicine/St Mary Medical Center
Authors
Alison Blodgett BA
Indiana University School of Medicine
Baraka Muvuka PhD, MPH
Indiana University School of Medicine