The role of comorbidities, medications, and social determinants of health in understanding urban-rural outcome differences among patients with heart failure

Journal of Rural Health

Zeitler EP, Joly J, Leggett CG, Wong SL, O'Malley AJ, Kraft SA, Mackwood MB, Jones ST, Skinner JS

There is now a 20% disparity in all-cause, excess deaths between urban and rural areas, much of which is driven by disparities in cardiovascular death. We sought to explain the sources of these disparities for Medicare beneficiaries with heart failure with reduced ejection fraction (HFrEF).

Among patients with HFrEF, living in a rural area is associated with an increased risk of death and return ER visits within 30 days of discharge from HF hospitalization. Differences in SDOH appear to partially explain mortality differences but the remaining gap may be the consequence of rural-urban differences in HF treatment.

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