The health services burden of heart failure: An analysis using linked population health data-sets

Jane Robertson, Patrick McElduff, Sallie Anne Pearson, David A. Henry, Kerry J. Inder, John R. Attia

Research output: Contribution to journalArticleResearchpeer-review

34 Citations (Scopus)

Abstract

Background: The burden of patients with heart failure on health care systems is widely recognised, although there have been few attempts to quantify individual patterns of care and differences in health service utilisation related to age, socio-economic factors and the presence of co-morbidities. The aim of this study was to assess the typical profile, trajectory and resource use of a cohort of Australian patients with heart failure using linked populationbased, patient-level data. Methods: Using hospital separations (Admitted Patient Data Collection) with death registrations (Registry of Births, Deaths and Marriages) for the period 20002007 we estimated age- and gender-specific rates of index admissions and readmissions, risk factors for hospital readmission, mean length of stay (LOS), median survival and bed-days occupied by patients with heart failure in New South Wales, Australia. Results: We identified 29,161 index admissions for heart failure. Admission rates increased with age, and were higher for males than females for all age groups. Age-standardised rates decreased over time (256.7 to 237.7/ 100,000 for males and 235.3 to 217.1/100,000 for females from 20023 to 20067; p = 0.0073 adjusted for gender). Readmission rates (any cause) were 27% and 73% at 28-days and one year respectively; readmission rates for heart failure were 11% and 32% respectively. All cause mortality was 10% and 28% at 28 days and one year. Increasing age was associated with more heart failure readmissions, longer LOS and shorter median survival. Increasing age, increasing Charlson comorbidity score and male gender were risk factors for hospital readmission. Cohort members occupied 954,888 hospital bed-days during the study period (any cause); 383,646 bed-days were attributed to heart failure admissions. Conclusions: The rates of index admissions for heart failure decreased significantly in both males and females over the study period. However, the impact on acute care hospital beds was substantial, with heart failure patients occupying almost 200,000 bed-days per year in NSW over the five year study period. The strong age-related trends highlight the importance of stabilising elderly patients before discharge and community-based outreach programs to better manage heart failure and reduce readmissions.

Original languageEnglish
Article number103
JournalBMC Health Services Research
Volume12
Issue number1
DOIs
Publication statusPublished - 2012
Externally publishedYes

Fingerprint

Health Services
Heart Failure
Health
Population
Patient Readmission
Length of Stay
Datasets
Community-Institutional Relations
South Australia
New South Wales
Survival
Patient Discharge
Marriage
Registries
Comorbidity
Age Groups
Economics
Parturition
Morbidity
Delivery of Health Care

Cite this

Robertson, Jane ; McElduff, Patrick ; Pearson, Sallie Anne ; Henry, David A. ; Inder, Kerry J. ; Attia, John R. / The health services burden of heart failure : An analysis using linked population health data-sets. In: BMC Health Services Research. 2012 ; Vol. 12, No. 1.
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title = "The health services burden of heart failure: An analysis using linked population health data-sets",
abstract = "Background: The burden of patients with heart failure on health care systems is widely recognised, although there have been few attempts to quantify individual patterns of care and differences in health service utilisation related to age, socio-economic factors and the presence of co-morbidities. The aim of this study was to assess the typical profile, trajectory and resource use of a cohort of Australian patients with heart failure using linked populationbased, patient-level data. Methods: Using hospital separations (Admitted Patient Data Collection) with death registrations (Registry of Births, Deaths and Marriages) for the period 20002007 we estimated age- and gender-specific rates of index admissions and readmissions, risk factors for hospital readmission, mean length of stay (LOS), median survival and bed-days occupied by patients with heart failure in New South Wales, Australia. Results: We identified 29,161 index admissions for heart failure. Admission rates increased with age, and were higher for males than females for all age groups. Age-standardised rates decreased over time (256.7 to 237.7/ 100,000 for males and 235.3 to 217.1/100,000 for females from 20023 to 20067; p = 0.0073 adjusted for gender). Readmission rates (any cause) were 27{\%} and 73{\%} at 28-days and one year respectively; readmission rates for heart failure were 11{\%} and 32{\%} respectively. All cause mortality was 10{\%} and 28{\%} at 28 days and one year. Increasing age was associated with more heart failure readmissions, longer LOS and shorter median survival. Increasing age, increasing Charlson comorbidity score and male gender were risk factors for hospital readmission. Cohort members occupied 954,888 hospital bed-days during the study period (any cause); 383,646 bed-days were attributed to heart failure admissions. Conclusions: The rates of index admissions for heart failure decreased significantly in both males and females over the study period. However, the impact on acute care hospital beds was substantial, with heart failure patients occupying almost 200,000 bed-days per year in NSW over the five year study period. The strong age-related trends highlight the importance of stabilising elderly patients before discharge and community-based outreach programs to better manage heart failure and reduce readmissions.",
author = "Jane Robertson and Patrick McElduff and Pearson, {Sallie Anne} and Henry, {David A.} and Inder, {Kerry J.} and Attia, {John R.}",
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The health services burden of heart failure : An analysis using linked population health data-sets. / Robertson, Jane; McElduff, Patrick; Pearson, Sallie Anne; Henry, David A.; Inder, Kerry J.; Attia, John R.

In: BMC Health Services Research, Vol. 12, No. 1, 103, 2012.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The health services burden of heart failure

T2 - An analysis using linked population health data-sets

AU - Robertson, Jane

AU - McElduff, Patrick

AU - Pearson, Sallie Anne

AU - Henry, David A.

AU - Inder, Kerry J.

AU - Attia, John R.

PY - 2012

Y1 - 2012

N2 - Background: The burden of patients with heart failure on health care systems is widely recognised, although there have been few attempts to quantify individual patterns of care and differences in health service utilisation related to age, socio-economic factors and the presence of co-morbidities. The aim of this study was to assess the typical profile, trajectory and resource use of a cohort of Australian patients with heart failure using linked populationbased, patient-level data. Methods: Using hospital separations (Admitted Patient Data Collection) with death registrations (Registry of Births, Deaths and Marriages) for the period 20002007 we estimated age- and gender-specific rates of index admissions and readmissions, risk factors for hospital readmission, mean length of stay (LOS), median survival and bed-days occupied by patients with heart failure in New South Wales, Australia. Results: We identified 29,161 index admissions for heart failure. Admission rates increased with age, and were higher for males than females for all age groups. Age-standardised rates decreased over time (256.7 to 237.7/ 100,000 for males and 235.3 to 217.1/100,000 for females from 20023 to 20067; p = 0.0073 adjusted for gender). Readmission rates (any cause) were 27% and 73% at 28-days and one year respectively; readmission rates for heart failure were 11% and 32% respectively. All cause mortality was 10% and 28% at 28 days and one year. Increasing age was associated with more heart failure readmissions, longer LOS and shorter median survival. Increasing age, increasing Charlson comorbidity score and male gender were risk factors for hospital readmission. Cohort members occupied 954,888 hospital bed-days during the study period (any cause); 383,646 bed-days were attributed to heart failure admissions. Conclusions: The rates of index admissions for heart failure decreased significantly in both males and females over the study period. However, the impact on acute care hospital beds was substantial, with heart failure patients occupying almost 200,000 bed-days per year in NSW over the five year study period. The strong age-related trends highlight the importance of stabilising elderly patients before discharge and community-based outreach programs to better manage heart failure and reduce readmissions.

AB - Background: The burden of patients with heart failure on health care systems is widely recognised, although there have been few attempts to quantify individual patterns of care and differences in health service utilisation related to age, socio-economic factors and the presence of co-morbidities. The aim of this study was to assess the typical profile, trajectory and resource use of a cohort of Australian patients with heart failure using linked populationbased, patient-level data. Methods: Using hospital separations (Admitted Patient Data Collection) with death registrations (Registry of Births, Deaths and Marriages) for the period 20002007 we estimated age- and gender-specific rates of index admissions and readmissions, risk factors for hospital readmission, mean length of stay (LOS), median survival and bed-days occupied by patients with heart failure in New South Wales, Australia. Results: We identified 29,161 index admissions for heart failure. Admission rates increased with age, and were higher for males than females for all age groups. Age-standardised rates decreased over time (256.7 to 237.7/ 100,000 for males and 235.3 to 217.1/100,000 for females from 20023 to 20067; p = 0.0073 adjusted for gender). Readmission rates (any cause) were 27% and 73% at 28-days and one year respectively; readmission rates for heart failure were 11% and 32% respectively. All cause mortality was 10% and 28% at 28 days and one year. Increasing age was associated with more heart failure readmissions, longer LOS and shorter median survival. Increasing age, increasing Charlson comorbidity score and male gender were risk factors for hospital readmission. Cohort members occupied 954,888 hospital bed-days during the study period (any cause); 383,646 bed-days were attributed to heart failure admissions. Conclusions: The rates of index admissions for heart failure decreased significantly in both males and females over the study period. However, the impact on acute care hospital beds was substantial, with heart failure patients occupying almost 200,000 bed-days per year in NSW over the five year study period. The strong age-related trends highlight the importance of stabilising elderly patients before discharge and community-based outreach programs to better manage heart failure and reduce readmissions.

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