Analysis of trends in hospitalizations for heart failure.
BACKGROUND
Over the past 10 years, efforts have been made to control the cost of care for patients with congestive heart failure (CHF) through reducing hospitalizations and shortening lengths of stay. Few data are available regarding the effectiveness of these intervention strategies on a community basis.


RESULTS
We analyzed the Oregon hospital discharge database. Multivariable methods were used to assess trends while controlling for confounding factors, such as age, sex, and comorbidity. The hospital admission rates for CHF were stable over time in all age groups. The age- and sex-standardized admission rate among people aged 65 years or older decreased slightly from 13.9/1,000 in 1991 to 12.9/1,000 in 1995. The annual hospital readmission rate remained constant over time, with an average rate of 15.3%. The average length of hospital stay decreased from 5.01 days in 1991 to 3.95 days in 1995. The in-hospital mortality rate decreased from 6.9% in 1991 to 4.7% in 1995, independent of length of stay.


CONCLUSIONS
We observed stable hospital admission and readmission rates for CHF, accompanied by a decreasing trend in the length of hospital stay and in-hospital mortality. Our findings raise the possibility of improved care management for heart failure over time.
Oregon Heart Failure Project, Oregon Health Sciences University, Portland 97201-3098, USA.
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Hershberger
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015986:Confounding Factors, Epidemiologic; D003365:Costs and Cost Analysis; D005260:Female; D006333:Heart Failure / Q000191:economics / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007902:Length of Stay; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009922:Oregon / Q000453:epidemiology; D010343:Patient Admission / Q000191:economics / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000191:economics / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000191:economics / Q000706:statistics & numerical data; D012042:Registries; D017678:Sex Distribution