Low socioeconomic status, low health literacy, and inadequate insurance coverage increased 30-day heart failure readmission rates by 24%, 27%, and 21%, respectively.
Do adverse social determinants of health increase heart failure-related hospital readmissions in adults with heart failure?
Adverse social determinants of health, including low socioeconomic status and poor health literacy, significantly increase the risk of 30-day hospital readmissions in patients with heart failure, highlighting the need for targeted health equity strategies.
Heart failure is a leading cause of morbidity and mortality, with hospital readmissions contributing significantly to healthcare burden. Social determinants of health exacerbate disparities in outcomes, particularly among low-income, uninsured, and minority populations. This scoping review examined literature from the United States (2009–2024) using the Joanna Briggs Institute and PRISMA-ScR guidelines to identify social determinants of health and their influence on heart failure-related readmissions. Results of the review are structured using the Healthy People 2030 framework that included the categories of economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. Key determinants included socioeconomic status, education, health insurance, social support, and neighborhood environment. Patients with low socioeconomic status experience 24% higher 30-day readmission rates due to financial instability and restricted access to care. Low health literacy increases readmission risk by 27%, and inadequate insurance coverage is associated with a 21% higher likelihood of readmission. Minority and immigrant populations face compounded risks due to systemic inequities, with structural racism contributing to heart failure readmission rates that are 30% higher among minority immigrant groups. Additionally, environmental factors such as housing instability, food insecurity, and transportation barriers significantly impact heart failure management. Despite well-documented disparities, most studies used descriptive methods, highlighting a lack of tested, multi-component interventions to mitigate social determinate-related risks. The findings underscore the urgent need for policy reforms, community-based interventions, and targeted health equity strategies to reduce readmissions and improve outcomes.
Duran et al. (Sat,) conducted a review in Heart failure. Social determinants of health was evaluated on 30-day hospital readmission. Low socioeconomic status, low health literacy, and inadequate insurance coverage increased 30-day heart failure readmission rates by 24%, 27%, and 21%, respectively.