Abstract 13840: National and Regional Trends in Heart Failure Hospitalization and Mortality Rates for Medicare Beneficiaries: 1998-2008
Background: Whether recent declines in ischemic heart disease and its risk factors have been accompanied by declines in heart failure (HF) hospitalization and mortality is not known. We sought to examine changes in HF hospitalization rate and 1-year mortality rate, nationally and by U.S. state/territory.
Methods: All fee-for-service Medicare Part A beneficiaries hospitalized in acute care hospitals with a principal discharge diagnosis code for HF between 1998 and 2008 in the U.S. and Puerto Rico were identified. Risk-adjusted HF hospitalization and 1-year mortality rates were developed using hierarchical regression models with dummy indicator variables representing each year.
Results: The risk-adjusted HF hospitalization rate declined by 29.5%, from 2,845/100,000 person-years in 1998 to 2,007/100,000 person-years in 2008 (p<0.001). Age-adjusted HF-hospitalization rates declined over the study period for all race-sex categories, but black men had the lowest rate of decline. Declines in HF hospitalization rates were significantly higher than the national average in 16 states, and lower in 3 states. Risk-adjusted 1-year mortality fell by 6.6%, from 31.7% in 1999 to 29.6% in 2008 (p<0.001). 1-year mortality rate declined for all race-sex categories over the study period, except for non-white non-black women. 1-year mortality rates declined in 18 states, but increased in 6 states.
Conclusion: The overall HF hospitalization rate declined substantially from 1998 to 2008, but at a lower rate for black men, and 1-year mortality remains high. Changes in HF hospitalization and 1-year mortality rates were uneven across states.
- © 2011 by American Heart Association, Inc.