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Determinants of Health and Outcomes in Medicare Recipients With Heart Disease: A Population Study.

MedStar author(s):

Citation: Journal of Pain & Symptom Management. 2023 Aug 06PMID: 37544553Institution: MedStar Health Research Institute | MedStar Washington Hospital Center | MedStar Washington Hospital CenterDepartment: Medicine/Palliative Care | Medicine/Palliative CareForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2023 Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007ISSN:

0885-3924

Name of journal: Journal of pain and symptom managementAbstract: CONCLUSION: Higher risk SDoH profiles are associated with reduced HRQoL, reduced advance care planning completion, female sex, and non-White race in a cohort of Medicare beneficiaries. These findings provide opportunities to improve SDoH-related care practices in older patients with HD. Copyright © 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.CONTEXT: Heart disease (HD) is a primary cause of mortality and morbidity in the United States. While there is a growing body of evidence demonstrating the contribution of social determinants of health (SDoH) to HD outcomes, the impact of combined or individual SDoH on health-related quality of life (HRQoL) in patients with HD is not well understood.METHODS: The study design was a secondary data analysis using latent class analysis (LCA) and multivariable analysis of NHATS participants with HD, Round 8, that included End of Life Plans and Care questions.OBJECTIVES: To analyze the National Health and Aging Trends Study (NHATS) to explore the relationship of SDoH with HRQoL, advance care planning, and treatment preferences in Medicare beneficiaries with HD.RESULTS: 1202 participants, median age 81 years, 57% female, 70% non-Hispanic White, 20% non-Hispanic Black, 10% Other. LCA identified two SDoH risk profiles (low/high), using 12 measures within the NHATS Economic and Social Consequences key concept area. The high-risk SDoH profile participants were more likely to have fair/poor HRQoL, and identify as female, non-White (P < 0.0001); and less likely to have completed advance care planning (P < 0.0001). High-risk SDoH participants were more likely to want life-prolonging treatments (P < 0.0001), however, this association was not significant after adjusting for age, sex, and race (P = 0.344).All authors: Ahn J, Anderson KM, Groninger H, Rao A, Scally R, Weintraub WS, Xia Y, Yearwood EFiscal year: FY2024 Digital Object Identifier:

https://dx.doi.org/10.1016/j.jpainsymman.2023.08.001

Date added to catalog: 2023-10-04

Holdings ( 1 )
Title notes ( 7 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	37544553	Available		37544553

Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007

CONCLUSION: Higher risk SDoH profiles are associated with reduced HRQoL, reduced advance care planning completion, female sex, and non-White race in a cohort of Medicare beneficiaries. These findings provide opportunities to improve SDoH-related care practices in older patients with HD. Copyright © 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

CONTEXT: Heart disease (HD) is a primary cause of mortality and morbidity in the United States. While there is a growing body of evidence demonstrating the contribution of social determinants of health (SDoH) to HD outcomes, the impact of combined or individual SDoH on health-related quality of life (HRQoL) in patients with HD is not well understood.

METHODS: The study design was a secondary data analysis using latent class analysis (LCA) and multivariable analysis of NHATS participants with HD, Round 8, that included End of Life Plans and Care questions.

OBJECTIVES: To analyze the National Health and Aging Trends Study (NHATS) to explore the relationship of SDoH with HRQoL, advance care planning, and treatment preferences in Medicare beneficiaries with HD.

RESULTS: 1202 participants, median age 81 years, 57% female, 70% non-Hispanic White, 20% non-Hispanic Black, 10% Other. LCA identified two SDoH risk profiles (low/high), using 12 measures within the NHATS Economic and Social Consequences key concept area. The high-risk SDoH profile participants were more likely to have fair/poor HRQoL, and identify as female, non-White (P < 0.0001); and less likely to have completed advance care planning (P < 0.0001). High-risk SDoH participants were more likely to want life-prolonging treatments (P < 0.0001), however, this association was not significant after adjusting for age, sex, and race (P = 0.344).

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