Neighborhood environments and heart failure outcomes in the Get With The Guidelines-Heart Failure Registry

The aim of this project is to examine rural-urban differences in the associations of neighborhood-level social determinants of health (SDOH) factors with in-hospital mortality and quality of care among patients hospitalized with heart failure (HF). Within this aim, we have three objectives: 1) Link additional SDOH data to Get With The Guidelines (GWTG)-HF Registry analytic file, 2) Examine the associations of neighborhood-level SDOH factors with in-hospital mortality and heart failure quality of care, and 3) Examine if the associations of neighborhood-level SDOH factors with in-hospital mortality and heart failure quality of care differ across rural and urban areas. We will use a cross-sectional study design with the GWTG-HF Registry with data from 2011-2019. We will include neighborhood-level SDOH factors from five domains: economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context. Multilevel models will be used to estimate associations of neighborhood-level SDOH factors with in-hospital mortality and meeting GWTG quality of care metrics. Identifying specific SDOH factors associated with poor heart failure outcomes will highlight areas to place interventions to strengthen heart failure care in rural and urban communities.

Scholars @ ECU