Abstract
Background:
Readmissions have a significant economic impact on the healthcare burden of atrial fibrillation (AF). Health Related Social Needs (HRSN) contribute to poor outcomes including readmissions. Differences in readmission rates related to sex are unclear.
Methods:
Data were abstracted from the 2016 to 2018 National Readmission Database (NRD). The primary outcome was all-cause 30-day readmission following discharge for index AF. We identified HRSN (employment, family, housing, psychosocial, and socioeconomic status [SES]) using ICD-10 codes. Using multivariable logistic regression models, we evaluated whether the association between HRSN and readmission differed between males and females.
Results:
We identified 614,520 AF hospitalizations, which included 51% female and 49% male. The overall readmissions rate was 14.5% (95% CI: 14.4%, 14.6%). The adjusted odds of readmissions in the presence of housing, family, or psychosocial HRSN were statistically higher for males compared to females (all interaction p < .05), whereas the association between readmission and employment and SES were statistically similar. Overall, the strongest association with readmission was observed for housing (Table 1).
Conclusion:
Males with housing, family, and psychosocial HRSN have a higher risk of readmissions for AF
.
Further study is needed to address why these sex-based disparities exist and what interventions that impact HRSN may result in improved outcomes.