Date of Conferral

2019

Degree

Ph.D.

School

Public Health

Advisor

Patrick B. Williams

Abstract

Abstract

African Americans are disproportionately affected by heart failure, with prevention and treatment of heart failure being a public health concern in the United States. The purpose of this retrospective quantitative study was to examine the primary variable race, specifically African Americans, and how this variable relates to 30-day readmission post discharge when controlled with geographic location (urban vs. rural), gender, and insurance status. The expanded chronic care model was used as a framework to shape health promotion, prevention efforts, and social determinants of health and to enhance community involvement related to chronic disease issues. The research questions were focused on determining a relationship among African Americans being at a higher risk for 30-day readmission than others using selected control variables. Secondary data were collected for 565 patients diagnosed with congestive heart failure from the 2015 Hospital Inpatient Discharges data set and analyzed using simple and multivariate logistic regression methods to answer research questions and test hypotheses. Key results of the simple logistic regression revealed that African Americans were 1.7 times more likely to be readmitted than other races and 1.3 times more likely to be readmitted than Caucasians. The multiple logistic regression revealed race, gender and geographic location (urban) as significant predictors of readmission among African Americans. Insurance status revealed no significance for readmission among African Americans. Implications for social change from this study may include policy implementation at the family, organizational, and societal levels, such as policy related to education on establishing a surveillance system that identifies those in the population who are at risk and more vulnerable to social and health care disparities.

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