Short‐ and Long‐term Rehospitalization and Mortality for Heart Failure in 4 Racial/Ethnic Populations

Abstract

Background The degree to which outcomes following hospitalization for acute heart failure ( HF ) vary by racial and ethnic groups is poorly characterized. We sought to compare 30‐day and 1‐year rehospitalization and mortality rates for HF among 4 race/ethnic groups. Methods and Results Using the Get With The Guidelines– HF registry linked with Medicare data, we compared 30‐day and 1‐year outcomes between racial/ethnic groups by using a multivariable Cox proportional hazards model adjusting for clinical, hospital, and socioeconomic status characteristics. We analyzed 47 149 Medicare patients aged ≥65 years who had been discharged for HF between 2005 and 2011: there were 39 213 whites (83.2%), 4946 blacks (10.5%), 2347 Hispanics (5.0%), and 643 Asians/Pacific Islanders (1.4%). Relative to whites, blacks and Hispanics had higher 30‐day and 1‐year unadjusted readmission rates but lower 30‐day and 1‐year mortality; Asians had similar 30‐day readmission rates but lower 1‐year mortality. After risk adjustment, blacks had higher 30‐day and 1‐year CV readmission than whites but modestly lower short‐ and long‐term mortality; Hispanics had higher 30‐day and 1‐year readmission rates and similar 1‐year mortality than whites, while Asians had similar outcomes. When socioeconomic status data were added to the model, the majority of associations persisted, but the difference in 30‐day and 1‐year readmission rates between white and Hispanic patients became nonsignificant. Conclusions Among Medicare patients hospitalized with HF , short‐ and long‐term readmission rates and mortality differed among the 4 major racial/ethnic populations and persisted even after controlling for clinical, hospital, and socioeconomic status variables.