Health Related Quality of Life in Hispanic Versus Non-Hispanic White Congestive Heart Failure Patients and Predictors of Healthcare Utilization

Congestive heart failure (CHF) is a prevalent disease in the US. CHF diminishes health related quality of life (HRQOL) to those who have it. Evaluation of HRQOL between Hispanic and non-Hispanic White CHF patients were conducted. OBJECTIVES: To determine if there are mean-score differences in HRQOL between Hispanic and non-Hispanic White CHF patients using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). To examine the relationship of HRQOL in these two groups with: (1) hospital admissions, (2) emergency department (ED) visits, (3) CHF clinic visits, and (4) a combination of all three within a 6-month period after completing the MLHFQ. To examine the relationship between the self-reported Patient Health Questionnaire-9 (PHQ-9) depression scores and HRQOL scores in both groups. To test the ability of various conceptually constructed risk models to predict hospital admissions, ED visits, visits to the CHF clinic, and a composite of outcomes. METHODS: Cross-sectional and retrospective cohort designs were conducted. All patients evaluated in this study were from the CHF clinic at the University of New Mexico Hospitals. Non-Hispanic White patients served as the comparison group. RESULTS: No statistical differences in total MLHFQ or MLHFQ subscale scores were found between the two groups. There were no significant differences in hospital admissions, ED visits, CHF clinic visits, or composite of all three between the two groups. Hispanic patients had a stronger correlation between PHQ-9 and MLHFQ total and physical scores than non-Hispanic White patients. There was no difference between the two groups in the PHQ-9 and MLHFQ emotional scores. Only the severity of illness (3a) model predicted hospital admissions, ED visits, CHF clinic visits, and composite of all three. CONCLUSIONS: This study shows no differences between HRQOL, healthcare utilization, or ethnicity predicting healthcare utilization between Hispanic and non-Hispanic White CHF patients. While there is a difference between Hispanic and non-Hispanic White CHF patients in terms of PHQ-9 and MLHFQ total and physical subscale scores, it is unknown what, if any, clinical significance this has. A larger multi-site study measuring outcomes prospectively with more than one HRQOL instrument is necessary to provide more information on this topic