Low income decreases odds of cardiologist involvement in heart failure hospital care
Adults with low household income are less likely to have a cardiologist involved in their care during hospitalization for heart failure than adults with higher incomes, according to a study published online Nov. 20 in JAMA Network Open.
David T. Zhang, M.D., from Weill Cornell Medicine in New York City, and colleagues assessed whether nine social determinants of health (SDOH) are associated with cardiologist involvement in the management of adults hospitalized for heart failure. The analysis included data from 1,000 participants in the Reasons for Geographic and Racial Difference in Stroke cohort treated at 549 unique U.S. hospitals.
The researchers found that low annual household income (<$35,000) was the only SDOH with a statistically significant association with cardiologist involvement (relative risk, 0.88). When adjusting for age, race, sex, heart failure characteristics, comorbidities, and hospital characteristics, low income remained inversely associated with cardiologist involvement (adjusted relative risk, 0.89).
"This cohort study found that adults with low household income were 11 percent less likely than adults with higher incomes to have a cardiologist involved in their care during a hospitalization for heart failure," the authors write. "This suggests that certain social factors may bias the care provided to patients hospitalized for heart failure, calling attention to a potentially important source of disparity in care."
More information: David T. Zhang et al, Social Determinants of Health and Cardiologist Involvement in the Care of Adults Hospitalized for Heart Failure, JAMA Network Open (2023). DOI: 10.1001/jamanetworkopen.2023.44070
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