Abstract
CONTEXT: 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. OBJECTIVE: To examine changes in HF hospitalization rate and 1-year mortality rate in the U.S., nationally and by state/territory. DESIGN, SETTING, AND PARTICIPANTS: 55,097,390 fee-for-service Medicare beneficiaries hospitalized between 1998 and 2008 in acute care hospitals in the U.S. and Puerto Rico admitted with a principal discharge diagnosis code for HF. MAIN OUTCOME MEASURES: Changes in patient demographics and comorbidities, HF hospitalization rates, and 1-year mortality rates. RESULTS: The HF hospitalization rate adjusted for age, sex, and race declined from 2,845 per 100,000 person-years in 1998 to 2,007 per 100,000 person-years in 2008 (p<0.001), a relative decline of 29.5%. Age-adjusted HF-hospitalization rates declined over the study period for all race-sex categories. Black men had the lowest rate of decline (4,142 to 3,201 per 100,000 person-years) among all race-sex categories which persisted after adjusting for age (incidence rate ratio=0.81, 95% confidence interval [CI] 0.79 to 0.84). HF hospitalization rates declined significantly faster than the national mean in 16 states, and significantly slower in 3 states. Risk-adjusted 1-year mortality fell from 31.7% in 1999 to 29.6% in 2008 (p<0.001), a relative decline of 6.6%. 1-year mortality rates declined significantly in 4 states, but increased in 5 states. CONCLUSIONS: The overall HF hospitalization rate declined substantially from 1998 to 2008, but at a lower rate for black men. The overall 1-year mortality rate declined slightly over the past decade, but remains high. Changes in HF hospitalization and 1-year mortality rates were uneven across states.
Keywords
MedicineDemographyHeart failureMortality rateContext (archaeology)Incidence (geometry)DemographicsGerontologyInternal medicine
MeSH Terms
Black or African AmericanAge FactorsAgedAged80 and overCohort StudiesComorbidityFemaleHeart FailureHospitalizationHospitalsHumansMaleMedicareMortalityRetrospective StudiesSex FactorsUnited States
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Publication Info
- Year
- 2011
- Type
- article
- Volume
- 306
- Issue
- 15
- Pages
- 1669-1669
- Citations
- 737
- Access
- Closed
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Cite This
Jersey Chen,
Sharon‐Lise T. Normand,
Yun Wang
et al.
(2011).
National and Regional Trends in Heart Failure Hospitalization and Mortality Rates for Medicare Beneficiaries, 1998-2008.
JAMA
, 306
(15)
, 1669-1669.
https://doi.org/10.1001/jama.2011.1474
Identifiers
- DOI
- 10.1001/jama.2011.1474
- PMID
- 22009099
- PMCID
- PMC3688069