Heart failure & cardiomyopathies

Association of Neighbourhood-Level Material Deprivation with Adverse Outcomes and Processes of Care Among Patients with Heart Failure in a Single-Payer Healthcare System: A Population-Based Cohort Study

Eur J Heart FailPublished Population-based retrospective cohort study

Authors' conclusion

Patients with newly-diagnosed heart failure residing in the most deprived neighbourhoods had worse outcomes and reduced access to care than those less deprived.

Study context

Population
Incident HF patients in a universal healthcare system, 2007–2019
Participants
395,763 patients
Exposure
Most vs least deprived neighbourhoods
Outcome
All-cause mortality, cause-specific hospitalization and processes of care
Follow-up
1 year (mortality); 90 days (processes of care)
Methodological detailscause-specific hazards regression, multiple covariate adjustment, stratified by age
  • Cause-specific hazards regression
  • Multiple covariate adjustment
  • Stratified by age

Main finding

As reported in the abstract

1 year
Most deprived vs Least deprivedHazard ratio (95% CI)
Age ≤65 years; all-cause death
1.19(1.10–1.29)
Age ≤65 years; CV hospitalization
1.29(1.19–1.39)
Age ≥66 years; death
1.11(1.08–1.14)
Age ≥66 years; CV hospitalization
1.13(1.09–1.18)

Observational data: associations, not effects.

Further findings

Processes of care: cardiology visits and advanced cardiac imaging · 90 days

Lower hazard in more deprived individuals, both age groups
all p < 0.001

ICD/CRT-pacemaker implantation (age ≤65 years) · 90 days

Most deprived less likely to undergo implantation vs least deprived
P = 0.023

Original publication

Association of Neighbourhood-Level Material Deprivation with Adverse Outcomes and Processes of Care Among Patients with Heart Failure in a Single-Payer Healthcare System: A Population-Based Cohort Study. Eur J Heart Fail. Published 20 December 2023. doi:10.1002/ejhf.3090

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