Socioeconomic, Psychosocial and Behavioral Characteristics of Patients Hospitalized With Cardiovascular Disease

Am J Med Sci. 2017 Dec;354(6):565-572. doi: 10.1016/j.amjms.2017.07.011. Epub 2017 Jul 25.

Abstract

Background: Recent studies have drawn attention to nonclinical factors to better understand disparities in the development, treatment and prognosis of patients with cardiovascular disease. However, there has been limited research describing the nonclinical characteristics of patients hospitalized for cardiovascular care.

Methods: Data for this study come from 520 patients admitted to the Duke Heart Center from January 1, 2015 through January 10, 2017. Electronic medical records and a standardized survey administered before discharge were used to ascertain detailed information on patients' demographic (age, sex, race, marital status and living arrangement), socioeconomic (education, employment and health insurance), psychosocial (health literacy, health self-efficacy, social support, stress and depressive symptoms) and behavioral (smoking, drinking and medication adherence) attributes.

Results: Study participants were of a median age of 65 years, predominantly male (61.4%), non-Hispanic white (67.1%), hospitalized for 5.11 days and comparable to all patients admitted during this period. Results from the survey showed significant heterogeneity among patients in their demographic, socioeconomic and behavioral characteristics. We also found that the patients' levels of psychosocial risks and resources were significantly associated with many of these nonclinical characteristics. Patients who were older, women, nonwhite and unmarried had generally lower levels of health literacy, self-efficacy and social support, and higher levels of stress and depressive symptoms than their counterparts.

Conclusions: Patients hospitalized with cardiovascular disease have diverse nonclinical profiles that have important implications for targeting interventions. A better understanding of these characteristics will enhance the personalized delivery of care and improve outcomes in vulnerable patient groups.

Keywords: Cardiovascular disease; Hospitalization; Nonclinical factors; Psychosocial factors; Socioeconomic status.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Cardiovascular Diseases / economics
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / psychology
  • Depression / epidemiology
  • Female
  • Health Literacy
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Marital Status
  • Psychology
  • Risk Factors
  • Self Efficacy
  • Sex Factors
  • Social Support
  • Socioeconomic Factors
  • Stress, Psychological / epidemiology
  • Surveys and Questionnaires