Social Determinants for Health and Hospitalizations in Atrial Fibrillation

Atrial fibrillation (AF) imposes a significant burden on the health care system, “with rehospitalizations as one of the most significant factors,” according to a study presented at ACC.22. The primary investigator, Azka Latif, and colleagues sought to uncover associations between hospital readmissions for AF and Social Determinants of Health (SocDH) via ICD-10 codes for Health-Related Social Needs (HSRNs) in Nationwide Readmissions Database (NRD) cases. Among their factors of interest, insufficient housing was found to be the main SocDH associated with increased 30-day readmissions.

The researchers utilized NRD readmission reports from 2016 to 2018, encompassing a total of 614,520 AF hospitalizations—of which 14.5% involved readmission (95% confidence interval [CI], 14.4–14.6%; p <0.001). The primary measure was all-cause 30-day readmission following discharge for AF. The SocDH factors examined in the study included housing, socioeconomic status (SES), family, employment, and psychosocial.

According to the report, the two most common causes for readmissions within 30-days of AF discharge were cardiac arrhythmia (25%) and heart failure (13%). The authors noted that, when there was more than one HRSNs code, the rates of readmission were even higher. While the unadjusted analysis associated housing, employment, and SES with readmission, only housing remained significant in adjusted models (adjusted odds ratio [aOR] = 2.3; 95% CI, 2.1–2.5; p <0.001).

The study’s authors therefore drew the conclusion that “interventions to reduce readmissions for socially vulnerable patients will need to address housing insecurity.”