Heart failure & cardiomyopathiesCohort study
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
- Population-based retrospective cohort study
- cause-specific hazards regression
- multiple covariate adjustment
- stratified by age
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)
Main finding
As reported in the abstract
All-cause death and CV hospitalization, by age stratum · 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
Summarised from the published abstract; every number is checked against it