What is the clinical evidence from this study?

Study design: Cohort. Population: Heart failure (n=16324). Intervention: Black race vs. White race. Primary outcome: 30-day hospital readmission (aOR 1.37, 95% CI 1.21-1.56, p=<0.001).

What does this research mean for the field?

Among critically ill patients with heart failure, Black and Hispanic race are associated with significantly higher odds of 30-day hospital readmission compared to White race, while private insurance is associated with lower odds compared to Medicare. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the association between selected social determinants of health and 30-day hospital readmission among critically ill adult patients with heart failure.

June 27, 2026CureusOpen Access

Association Between Social Determinants of Health and Readmission Outcomes in Heart Failure: A Retrospective Cohort Study Using Medical Information Mart for Intensive Care IV (MIMIC-IV)

Q: What are the key findings of this study?

Black race was associated with significantly higher odds of 30-day hospital readmission (aOR 1.37) compared to White race among critically ill patients with heart failure.

Q: What does this research mean for the field?

Among critically ill patients with heart failure, Black and Hispanic race are associated with significantly higher odds of 30-day hospital readmission compared to White race, while private insurance is associated with lower odds compared to Medicare. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the association between selected social determinants of health and 30-day hospital readmission among critically ill adult patients with heart failure.

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Key result

Black race linked to ~37% higher 30-day readmission odds in critically ill HF patients.

aOR 1.37
95% CI 1.21-1.56
P<0.001
n=16,324

Why the study?

Heart failure is a major contributor to hospital readmissions, but the role of social determinants of health in post-discharge outcomes among critically ill patients is not fully characterized.

Do social determinants of health (insurance type, marital status, race) influence 30-day readmission in critically ill patients with heart failure?

Key Points

To evaluate the association between selected social determinants of health and 30-day hospital readmission among critically ill adult patients with heart failure.
Retrospective cohort study of N=16,324 adult intensive care unit patients with heart failure identified from the Medical Information Mart for Intensive Care IV (MIMIC-IV) version 3.1 database.
Evaluated the impact of insurance type, marital status, and race on 30-day readmission using multivariable logistic regression adjusted for age, sex, Charlson Comorbidity Index, Sequential Organ Failure Assessment score, and length of stay.
The overall 30-day hospital readmission rate was 17.6% (2,880 of 16,324 patients).
Black patients (aOR: 1.37, 95% CI: 1.21 to 1.56, p<0.001) and Hispanic patients (aOR: 1.31, 95% CI: 1.04 to 1.64, p=0.020) had significantly higher odds of 30-day readmission compared to White patients.
Private insurance was associated with lower readmission odds compared to Medicare (aOR: 0.83, 95% CI: 0.73 to 0.95, p=0.008), while a higher Charlson Comorbidity Index increased readmission risk (aOR: 1.04, 95% CI: 1.03 to 1.06, p<0.001).

Study Design

Type

Cohort (n=16,324)

Multicenter

Structured PICO

Do social determinants of health (insurance type, marital status, race) influence 30-day readmission in critically ill patients with heart failure?

Population

16,324 critically ill adult patients with heart failure admitted to the intensive care unit, evaluated for 30-day hospital readmission.

Exposure

Social determinants of health exposures (insurance type, marital status, and race).

Comparator

Reference categories within social determinants (e.g., White race, Medicare insurance, married status).

Outcome

30-day hospital readmission.hard clinical

Main Result

Odds Ratio: 1.37 (95% CI 1.21–1.56)

p-value: p=<0.001

Social determinants of health, including race and insurance type, are significantly associated with 30-day readmission risk in critically ill patients with heart failure.

Limitations

Relied on routinely collected electronic health record data, which may be subject to misclassification or coding inaccuracies
Social determinants of health were represented using proxy variables that may not fully capture socioeconomic conditions or structural determinants
Only the first ICU admission per patient was included, which may underestimate the burden of recurrent readmissions
Restricted to patients admitted to the intensive care unit, limiting generalizability to the broader population of hospitalized patients with heart failure
Lacked detailed information on heart failure subtypes (e.g., HFrEF, HFpEF)
Observational design limits the ability to infer causal relationships
Derived from a single tertiary academic medical center, limiting external generalizability
Exclusion of patients with recurrent heart failure admissions who are at particularly high risk of readmission and adverse outcomes (due to retaining only the first ICU stay)

Discussion

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Implication

Highlights racial disparities in HF readmissions; leaves open whether targeted SDOH interventions improve outcomes.

Cite This Study

Odoeke et al. (2026) conducted a cohort in Heart failure (n=16,324). Black race vs. White race was evaluated on 30-day hospital readmission (aOR 1.37, 95% CI 1.21-1.56, p=<0.001). Black race was associated with significantly higher odds of 30-day hospital readmission (aOR 1.37) compared to White race among critically ill patients with heart failure.

synapsesocial.com/papers/6a3f67e2aea7db3c1953f1e8 https://doi.org/10.7759/cureus.111435

Topics

Heart failure HFrEF treatment Heart failure hospitalization

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Association Between Social Determinants of Health and Readmission Outcomes in Heart Failure: A Retrospective Cohort Study Using Medical Information Mart for Intensive Care IV (MIMIC-IV)

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Topics

Association Between Social Determinants of Health and Readmission Outcomes in Heart Failure: A Retrospective Cohort Study Using Medical Information Mart for Intensive Care IV (MIMIC-IV)

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider