An article examining the changes in age, health complexity and disease type in people seen by a heart failure outreach service in Sydney from 2002-2014

Abstract

Introduction: Since 2001 the heart failure service at Prince of Wales Hospital, Randwick has evolved to enhance specialist multidisciplinary outreach care. Over time changes in service delivery have been necessary to meet the demands of increased utilisation of the service, growing health complexities and ageing of the population. Objectives: To identify the changes in characteristics and complex health needs of patients referred to and seen by the heart failure service between 2001 to 2005 and 2012 to 2014. Methods: A retrospective analysis of data available for all patients referred to the heart failure service in 2001-2005 and 2012-2014 examining patient age, heart failure with reduced versus preserved ejection fraction and number of serious comorbidities. Results: Data from all 870 patients referred and reviewed by the service from 2001-2005 (n=545) and 2012-2014 (n=325) were included for analysis. Significant changes were found between the two time periods in patients age (mean {SD}) from 76.8{10.7} vs 78.4{12.2} (p=0.04) and the number of serious comorbidities (3.2{1.6} vs 4.4{1.9}, p=<.01). The proportion of patients with heart failure preserved ejection fraction was also significantly higher over time (30.8% vs 51.3%, p=<.01.) Conclusion: Demand for community heart failure services appears to be increasing, with patients older in age, a higher prevalence of preserved ejection fraction heart failure and more comorbid conditions. To continue to ensure best practice as per national and international heart failure guideline recommendations, service provision and funding will need to be regularly reviewed and adapted to meet the changes in demand.