Examining the implications of social determinants of health on hospital readmission for patients with heart failure: a scoping review

Abstract

Abstract Heart failure is a leading cause of morbidity and mortality, with hospital readmissions contributing significantly to healthcare burden. Social determinants of health exacerbate disparities in outcomes, particularly among low-income, uninsured, and minority populations. This scoping review examined literature from the United States (2009–2024) using the Joanna Briggs Institute and PRISMA-ScR guidelines to identify social determinants of health and their influence on heart failure-related readmissions. Results of the review are structured using the Healthy People 2030 framework that included the categories of economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. Key determinants included socioeconomic status, education, health insurance, social support, and neighborhood environment. Patients with low socioeconomic status experience 24% higher 30-day readmission rates due to financial instability and restricted access to care. Low health literacy increases readmission risk by 27%, and inadequate insurance coverage is associated with a 21% higher likelihood of readmission. Minority and immigrant populations face compounded risks due to systemic inequities, with structural racism contributing to heart failure readmission rates that are 30% higher among minority immigrant groups. Additionally, environmental factors such as housing instability, food insecurity, and transportation barriers significantly impact heart failure management. Despite well-documented disparities, most studies used descriptive methods, highlighting a lack of tested, multi-component interventions to mitigate social determinate-related risks. The findings underscore the urgent need for policy reforms, community-based interventions, and targeted health equity strategies to reduce readmissions and improve outcomes.

Keywords

• Health disparities
• Heart failure
• Hospital readmissions
• Social determinants of health
• Scoping review