Differences Between Frontier and Urban Elders With Chronic Heart Failure

Rowland, J. W.; Dimmler, Laura; Peters, Deborah

doi:10.1111/j.0889-7204.2004.02305.x

Cited by 7 publications

(3 citation statements)

References 22 publications

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“…Depending on geographic location, however, the majority of HF patients treated by a given facility may represent a distinctive population stratum with respect to ethnicity or socioeconomic status or both. Previous studies have shown that in patients with HF, ethnicity, socioeconomic status, and geographic location were associated with increased rates of hospitalization and rehospitalization, quality of life, and posthospitalization survival times 11–14 . Little is known, however, about the potential contribution of anemia to higher rates of morbidity and mortality in these patient subpopulations.…”

mentioning

confidence: 99%

The Effect of Anemia on Mortality in Indigent Patients With Mild‐to‐Moderate Chronic Heart Failure

Hebert

Horswell

Arcement

et al. 2006

Congestive Heart Failure

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Anemia has been described as an independent predictor of death in patients with chronic heart failure. Little is known, however, about the significance of anemia in heart failure patients with severely depressed socioeconomic backgrounds who receive comprehensive care in a heart failure management program. The impact of anemia on mortality was investigated in 410 indigent chronic heart failure patients, the majority of whom were in New York Heart Association functional class I-III and were treated with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and beta blockers at maximally tolerated doses. Anemia was present in 28% of patients. In an adjusted Cox analysis, anemia was strongly associated with mortality, but only in men: hazard ratio, 2.54; 95% confidence interval, 1.31-4.93; p = 0.006. The investigators conclude that anemia in this population is common and that, for men, the relative risk increase associated with anemia is high.

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confidence: 99%

The Effect of Anemia on Mortality in Indigent Patients With Mild‐to‐Moderate Chronic Heart Failure

Hebert

Horswell

Arcement

et al. 2006

Congestive Heart Failure

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“…Rural medical institutions also have limited technological and clinical resources and employ fewer cardiovascular specialists than urban hospitals (Casey et al, 2000, Bolin et al, 2011). Also, given the well documented association between hospital volume and quality of care, rural hospitals likely see a much lower volume of heart failure patients, and as a result could be less proficient at treating these patients than their urban counterparts (Wagnild et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Congestive heart failure-related hospital deaths across the urban-rural continuum in the United States

Primm

Ferdinand

Callaghan

et al. 2019

Preventive Medicine Reports

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Congestive heart failure (CHF) is a growing public health problem that affects nearly 6.5 million individuals nationwide. Access to quality outpatient care and disease management programs has been shown to improve disease treatment and prognosis. Rural populations face unique challenges in the availability and accessibility of quality cardiovascular care. In 2018, we conducted a pooled cross-sectional analysis of the Nationwide Inpatient Sample (NIS) for 2009–2014 to examine recent trends in CHF-related hospital deaths in the United States, highlighting urban-rural differences within each census region. We performed a multivariable logistic regression analysis to compare the odds of CHF-related hospital death, by levels of rurality and within each census region. Most CHF-related hospital deaths occurred in the South and Midwest census regions and in large central metropolitan areas. Findings from census region stratified models revealed that non-core residents living within the West (OR 1.47, CI 1.26, 1.71), Midwest (OR 1.30, CI 1.17, 1.44), and South (OR = 1.21, 95% C.I. = 1.12–1.32) had a higher relative risk (but not higher absolute numbers) of experiencing death during a CHF-related hospitalization, compared to patients in large central metropolitan areas. Within each census region, there were also differences in odds of a CHF-related hospital death depending on patient sex, comorbidities, insurance type, median annual income, and year. As efforts to reduce rural health disparities in CHF morbidity continue, more work is needed to understand and test interventions to reduce the risk of death from CHF in noncore areas of the West, Midwest, and South.

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“…Compared to urban residents, patients in rural communities face greater challenges in managing their heart failure 10 . Difficulties include lack of local cardiac services and heart failure specialists 3 , 10 , lack of heart failure specific self-management guidance from providers 11 , 12 , less hospital discharge education at critical access hospitals, lack of follow-up by providers 13 , 14 , poor communication between the patient and providers, difficulty in traveling long distances for follow-up appointments and associated problems (time, fatigue, and cost) 11 , and feeling isolated and unsupported 15 , 16 . Despite these identified needs, effective programs to support heart failure patients in managing this complex, chronic condition in rural communities have not been reported 10 .…”

Section: Study Rationalementioning

confidence: 99%

Promoting self-management through adherence among heart failure patients discharged from rural hospitals: a study protocol

Young

Barnason

2015

F1000Res

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Heart failure is one of the most prevalent chronic conditions in Background adults, leading to prolonged morbidity, repeated hospitalizations, and placing tremendous economic burden on the healthcare system. Heart failure patients discharged from rural hospitals, or primarily critical access hospitals, have higher 30-day readmission and mortality rates compared to patients discharged from urban hospitals. Self-management improves heart failure patients' health outcomes and reduces re-hospitalizations, but adherence to self-management guidelines is low. We propose a home based post-acute care service managed by advanced practice nurses to enhance patient activation and lead to the improvement of self-management adherence in heart failure patients discharged from rural hospitals.This article describes the study design and research methods used Objective to implement and evaluate the intervention.Our intervention is a 12-week patient activation (Patient AcTivated Method Care at Home [PATCH]) to improve self-management adherence. Patients were randomized into two parallel groups (12-week PATCH intervention + usual care vs. usual care only) to evaluate the effectiveness of this intervention. Outcomes were measured at baseline, 3 and 6 months. Discussion This study aimed to examine the effectiveness of a rural theory based, advance F1000ResearchThis study aimed to examine the effectiveness of a rural theory based, advance practice nurse led, activation enhancing intervention on the self-management adherence in heart failure patients residing in rural areas. Our expectation is to facilitate adherence to self-management behaviors in heart failure patients following discharge from rural hospitals and decrease complications and hospital readmissions, leading to the reduction of economic burden. et al Creative Commons Attribution Licence permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The author(s) is/are employees of the US Government and therefore domestic copyright protection in USA does not apply to this work. The work may be protected under the copyright laws of other jurisdictions when used in those jurisdictions. Data associated with the article are available under the terms of the Creative (CC0 1.0 Public domain dedication). Commons Zero "No rights reserved" data waiverResearch reported in this publication was supported by the National Institutes Nursing Research of the National Institutes of Grant information: Health under award number 1R15NR 13769-01A1. The sponsor had no role in conducting the study, preparing and disseminating the study results. The authors are the recipients of the funding provided by the National Institutes Nursing Research of the National Institutes of Health. She has full access to the study data and takes responsibility for their integrity and the accuracy of the data analysis. Competing interests:No competing interests were disclosed. Page#6 -Participants -Inclusion criteria: modified the referenced web link fo...

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Differences Between Frontier and Urban Elders With Chronic Heart Failure

Cited by 7 publications

References 22 publications

The Effect of Anemia on Mortality in Indigent Patients With Mild‐to‐Moderate Chronic Heart Failure

The Effect of Anemia on Mortality in Indigent Patients With Mild‐to‐Moderate Chronic Heart Failure

Congestive heart failure-related hospital deaths across the urban-rural continuum in the United States

Promoting self-management through adherence among heart failure patients discharged from rural hospitals: a study protocol

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