Davis, Narda. Social determinants of health influence on re-admittance rates and mortality for the congestive heart failure patient: a systematic review. Retrieved from https://doi.org/doi:10.7282/t3-v7h0-ba63
DescriptionObjective: The objective of this Systematic Review was to examine the evidence on Social Determinants of Health (SDoH) (specifically, poverty/income and health literacy) to determine their influence on readmission and mortality rates in the cardiovascular-disease population.
Background: Heart disease claims over 600,000 lives per year in the United States. While healthcare has advanced in treatment, many socioeconomic factors lead to readmission and mortality in this population.
Inclusion criteria: Adult male and female patients, 65 years of age and older with a diagnosis of Congestive Heart Failure (CHF) who were readmitted following hospitalization for the same diagnosis.
Method: This is a systemic review of quantitative studies. The standard 3-step search strategy of JBI was used to find eligible studies. These were screened by title, abstract and full review for relevance. Critical appraisal and data extraction were performed by two reviewers working independently using the JBI SUMARI tools. The data extraction forms used were based on the selected study’s design.
Results: Of the initial 106 initial articles retrieved, seven full-text articles meeting all inclusion criteria were selected and appraised by two independent reviewers. Three of these articles were then excluded for unreliable results related to bias, and inadequate/lack of information in the article. Four articles were selected for extraction, analysis, and synthesis. These included one randomized control trial (RCT), one analytical cross-sectional study and two cohort studies. A narrative synthesis of these four articles was performed due to the lack of quantitative data to perform a meta-analysis.
Conclusions: The results of this review provide a greater understanding of the scope of healthcare determinants in society, including race, which is tied to economic issues. Among patients with heart failure over the age of 65 years, poverty was found to most influence readmittance rates and mortality rates, and a correlation was seen between low socioeconomic status and poor health literacy. Race was also a contributor as Black people tended to live in more impoverished areas and experienced higher readmission and mortality rates than White people living in the same area.