Increase in hospital admission rates for heart failure in The Netherlands, 1980-1993.

Abstract

Objective-To study the trend in hospital admission rates for heart failure in the Netherlands from 1980 to 1993. Design-All hospital admissions in the Netherlands with a principal discharge diagnosis of heart failure were analysed. In addition, individual records of heart failure patients from a subset of 7 hospitals were analysed to estimate the frequency and timing of readmissions. Results-The total number of discharges for men increased from 7377 in 1980 to 13 022 in 1993, and for women from 7064 to 12 944. From 1980 through 1993 age adjusted discharge rates rose 48% for men and 40% for women. Age adjusted inhospital mortality for heart failure decreased from 19% in 1980 to 15% in 1993. For all age groups in-hospital mortality for men was higher than for women. The mean length ofhospital admissions in 1993 was 14-0 days for men and 16-4 days for women. A review of individual patient records from a 6-3% sample of all hospital admissions in the Netherlands indicated that within a 2 year period 18% of the heart failure patients were admitted more than once and 5% more than twice. Conclusions-For both men and women a pronounced increase in age adjusted discharge rates for heart failure was observed in the Netherlands from 1980 to 1993. Readmissions were a prominent feature among heart failure patients. Higher survival rates after acute myocardial infarction and the longer survival of patients with heart disease, including heart failure may have contributed to the observed increase. The importance of advances in diagnostic tools and of possible changes in admission policy remain uncertain.

Predictors of Congestive Heart Failure Mortality in Elderly People From the General Population The CArdiovascular STudy in the ELderly (CASTEL)

“…CHF mortality was significantly (P < 0.05) higher in diabetic patients (11.4%) than in normoglycaemic subjects (8 …”

“…5) It is, therefore, not surprising that in the last two decades many papers have been devoted to the epidemiology, physiopathology, and etiology of CHF. 3,4,6) The most important data concerning the impact of CHF on public health derive from pharmacological trials, 7) hospital records, 8) and general practice studies, 9) and involve mainly subjects aged less than 65 years. On the contrary, only a limited number of studies have included elderly people from the general population.…”

Trends in the incidence and outcomes of heart failure in Ontario, Canada: 1997 to 2007

“…[16][17][18][19][20][21] However, incident and total admission rates decreased steadily thereafter. [22][23][24][25][26][27][28] Studies that examined population-based trends in the incidence of heart failure in the decades leading up to the 1990s showed weak correlation with hospital admission trends.…”

Home-Based Intervention in Congestive Heart Failure

“…1,2 In the UK, the proportion of healthcare funding directly attributable to CHF has almost doubled since 1990 to 2% of health expenditure in the year 2000. 3,4 As in other developed countries, 5,6 hospital activity represents the greatest component of cost. 3,4 Although some hospitalizations for CHF are central to its management, a large proportion are avoidable.…”