THE DISTRIBUTION OF CHF WITHIN SOUTHERN WEST VIRGINIA
Frank H Annie, PhD1; Muhammad Yasin, MD2,
Aravinda Nanjundappa, MD2;
1. CAMC Health Education and Research Institute
3200 MacCorkle Ave. SE, Charleston, WV 25304.
2. CAMC Vascular Center of Excellence, Charleston Area Medical Center.
3200 MacCorkle Ave SE, Charleston, WV 25304
Study Locations:
Charleston Area Medical Center, 3100 McCorkle Ave SE, Charleston, WV,
25302 and Charleston Area Medical Center Research Institute and Center
for Clinical Sciences Research, 3200 McCorkle Ave SE, Charleston, WV,
25302
Correspondence:
Frank Annie M.A; MPA, PhD
Research Scientist
CAMC Health Education and Research Institute
3200 MacCorkle Ave. SE,
Charleston, WV 25304
Phone 304-388-9921
Fax: 304-388-9921
Email: Frank.H.Annie@camc.org
Total word count: 593
Author Disclosure Block: None
Key words: Access, CHF
Running Title: The Distribution of CHF
Total Number of Tables and Figures: Figures 1
Per the United States (U.S) Census Bureau, rural areas are geographic
designations excluding all population, housing, and territory included
within an urbanized area or cluster (1). Approximately 20% of the U.S.
population lives in these rural designations. The literature reports
that rural populations face more barriers associated with access and
quality of care compared with urban groups. Cultural attitudes, access
difficulty, and absence of services are a few of several contributing
factors (2).
However, there is little evidence that specifically addresses the needs
of rural patients suffering from congestive heart failure (CHF). A
number of factors can cause CHF, including coronary artery disease,
valvular disease, and systemic hypertension. Poor health literacy,
roughly defined as the degree of difficulty an individual has while
attempting to obtain, process, and understand basic health information
and services, is associated with earlier heart failure hospitalization
and all-cause mortality in rural patients with CHF in the U.S. (3).
Elderly U.S. veterans who reside in rural designations are more
vulnerable to delayed CHF treatment due to lack of transportation (4).
Whether patients with CHF who reside in rural designations struggle to
comprehend information due to culturally-based reservations or lack
resources available to their urban counterparts, it is important to
identify those who require improved access so that their perspective and
needs can be better assessed. Appalachia is a distinct, non-homogenous
region within the U.S. that is comprised of 13 states, in which 42%
reside in rural areas or clusters (5). We conducted a retrospective
analysis of CHF cases from 2005-2016 obtained from our Charleston Area
Medical Center (CAMC) data warehouse in Charleston, West Virginia. Using
a Hot Spot Analysis, we aimed to identify patients with CHF from
rural territories and housing who have limited access. After the data
were analyzed (n=22,404), patients were identified and examined using
Arch 10.8 and geocoded. To investigate any potential spatial
relationships, and a Hot Spot Analysis was performed. We controlled for
population in order to understand the areas in which CHF had statistical
significant hot and cold zones.
The results suggest within (Figure 1) that areas in which CHF cases are
further from major hospitals in Southern West Virginia appear to have
increased cold spots within these zones. These zones are illustrated in
bright blue and have a (P = 0.001). These results suggest access and
health care resources are still a significant issue within Southern West
Virginia, as illustrated in (Figure 1). These at-risk zones are outside
the baseline 5 miles radius of the majority of substantial statistical
zones. These results also suggest that further access in the form of CHF
clinics and other households of access is essential.
Figure Legend
Figure 1 – Hot Spot Analysis of Congestive heart failure (CHF)
(n=22,404)