Date of Award
2025
Document Type
Dissertation
Selected Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Degree Name
Doctor of Philosophy (Ph.D.) Nursing
Department
Nursing
School
School of Nursing and Health Sciences
First Advisor
Aliya Kuerban
Abstract
Heart failure is a chronic, progressive condition affecting over 6 million adults in the United States and remains a leading cause of morbidity and mortality, contributing to approximately 380,000 deaths annually. Disparities in health outcomes for individuals with heart failure are further exacerbated by social determinants of health (SDoH), including socioeconomic status, healthcare accessibility, and availability of social support, particularly among vulnerable populations. Insurance coverage plays a critical role in influencing access to care, treatment adherence, and overall health outcomes among patients with heart failure. For patients receiving home health care (HHC) services, limited caregiver support and inadequate socioeconomic resources are associated with increased emergency department (ED) utilization, poor treatment adherence, and higher hospitalization rates. This study examined the relationships between type of insurance, living arrangement, SDoH factors, and ED utilization among adults with heart failure receiving HHC services. A retrospective, descriptive, and exploratory design was used to analyze secondary data extracted from the electronic health records (EHR) of one of the largest non-profit HHC agencies in the Northeastern United States. Descriptive analyses were conducted to characterize patient demographics, clinical profiles, and SDoH indicators. Exploratory analyses assessed the associations among caregiver availability, type of insurance coverage, and ED utilization within 30 days of HHC admission. Study findings demonstrated a significant association between the type of insurance coverage and ED utilization. Additionally, limitations in social resources were identified as a significant predictor of ED use. These findings highlight the critical role of SDoH and caregiver support in influencing health outcomes among adults with heart failure receiving HHC services.
This study supports the need for targeted interventions to implement strategies that promote health equity and develop a validated SDoH screening tool within HHC.
These efforts are essential to reducing preventable ED utilization and improving outcomes for adults with heart failure.
Related Pillar(s)
Study
Recommended Citation
Ramlogan, Lynette, "Factors Influencing Emergency Department Utilization Among Heart Failure Patients in the Home Health Care Setting: A Secondary Data Analysis" (2025). Theses & Dissertations. 214.
https://digitalcommons.molloy.edu/etd/214
