Hospitalizations for heart failure: Epidemiology and health system burden based on data gathered in routine practice

Abstract

PurposeTo analyze the epidemiological characteristics of heart failure (HF) and estimate the burden of the disease on the health service by means of real world data (RWD). Patients and methodsAll patients discharged from any Basque Health Service hospital after a first admission for HF between 2011 and 2015. Data sourcesDatabases of our health service. Outcomes30- and 365-day admissions, potentially avoidable hospitalizations (PAHs), mortality. Statistical analysisDescriptive statistics, age-standardized event rates. ResultsThe cohort was composed of 15,109 patients (mean age 79.8±10.1 years). At discharge patients had a median of 8 chronic conditions. 36% of them had had hospitalizations and 83% had visited a specialist (42% of them a cardiologist) during the previous year. Mortality was 24.5% within 365 days after discharge.Within 30 days after discharge, there were 2608 unplanned admissions, 49% for non-cardiovascular disease (CVD), 36% for HF and 15% for a CVD other than HF. 34% were classified as PAH. In the first 365 days after discharge, there were 14,559 hospitalizations, 54% for non-CVD reasons, 32% for HF and 13% for a CVD other than HF. Overall, 35% were PAHs. Conclusion(1) People admitted for HF are old, and they have multimorbidity and high rates of admissions due to non-CVD reasons and PAHs after discharge. These finding suggest the need of strengthening continuity of care and managing comorbidities. (2) Besides, most people admitted for HF have previous contacts with the Healthcare system, which suggests opportunities for prevention before disease worsening.