Organization of Heart Failure Care in Spain: Characteristics of Heart Failure Units

Abstract

3 (although that publication did not describe the criteria used to define the hospital type, which may have differed from those used here). Of the 151 centers, 56 (37.1%) have HF units. Of these, 16 are level 1 centers (28.6% of all units), 14 (25%) are level 2 centers, and 26 (46.4%) are level 3 centers. Heart failure units are currently found in 18.4% of level 1 centers, 42.4% of level 2 centers, and 83.9% of level 3 centers, figures only slightly higher than those for 2006 (P > .05 for all comparisons). Regarding unit type, 26 hospitals have only a general unit (46.4% of centers with an HF unit and 17.2% of the total), 12 have only an advanced unit (21.4% and 7.9%), and 18 have units of both types (32.1% and 11.9%). Centers with an HF unit are larger than those without one, have higher numbers of discharges of patients admitted for all causes (median 18 906 (7962-30 984) vs 6000 (3 498-13 154)) and for HF (661 (358-1027) vs 251 (121-493)), and also have more cardiologists (17 (9-23) vs 4 (2-9)). Of the 44 general HF units (26 as the only HF unit and 18 in centers that also have advanced units), most (n = 37 (84.1%)) are managed by the cardiology service and a few (n = 6 (13.6%)) are managed by internal medicine (the corresponding figures for 2006 were 91% and 9%). The cardiology service participates in 42 of the general units (95.5% vs 96% in 2006), internal medicine in 17 (38.6% vs 11% in 2006), rehabilitation in 9 (20.5% vs 9% in 2006), and geriatrics in 4 (9.1% vs 22% in 2006)—the same