Multidisciplinary interprofessional outpatient care improves mortality for patients
with heart failure (HF) but is underutilized. We sought to identify factors associated
with not establishing outpatient care among uninsured individuals with HF. We included
uninsured individuals referred to an interprofessional clinic after a hospitalization
with HF from 2016 to 2019. The primary outcome was establishing care, defined as presenting
to clinic within 7 days of discharge from the hospital. We constructed multivariable
adjusted logistic regression models to identify predictors of establishing care. A
total of 698 uninsured individuals were referred, of whom 583 (84%) established care.
Mean age was 49.5 ± 11 years, 15% were rural-dwelling, 59% were black, and 31% were
female. Black participants who were rural-dwelling (adusted odds ratio [aOR] 0.07,
95% confidence interval [CI] 0.03 to 0.17) or reported alcohol use (aOR 0.32, 95%
CI 0.16 to 0.64) had lower odds of establishing care. White participants who were
rural-dwelling (aOR 2.63, 95% CI 1.17 to 5.90) had higher odds of establishing care.
Uninsured black individuals with HF who live in rural communities or who are active
alcohol users represent a group that is at high risk of not establishing outpatient
follow-up after a hospitalization with HF. Efforts to reduce this disparity are warranted
to improve health outcomes in this population.
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Article Info
Publication History
Published online: July 16, 2022
Received in revised form:
May 20,
2022
Received:
February 18,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Funding: None.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
