Transitions in health status in older patients with heart failure.
BACKGROUND
We aimed to determine transitions in health perception and functional status in older Medicare patients with heart failure.


METHODS
We used 1991 to 1994 data from the Medicare Current Beneficiary Survey, a database that combines Medicare claims with yearly longitudinal surveys. We identified 872 patients 65 years or older in 1991 with a diagnostic code of heart failure.


RESULTS
At baseline, 58% of the patients rated their general health perception as "fair" or "poor." Over 1 year, 18% of the patients died. Transition matrices revealed that health perception, activities of daily living, and instrumental activities of daily living were strong correlates of mortality; that dramatic changes in health status were relatively uncommon over 1 year among survivors; and that decline was common in patients with "excellent" or "very good" health perception. The prior year's health status and comorbidity were powerful predictors of the subsequent year's health status.


CONCLUSIONS
Many older patients with heart failure have worsening health status over time. Measures of prior health status can help predict chances of functional recovery.
Chin
Marshall H
MH
Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL 60637, USA. mchin@medicine.bsd.uchicago.edu
Zhang
James X
JX
Rathouz
Paul J
PJ
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006333:Heart Failure / Q000401:mortality* / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D008297:Male; D011788:Quality of Life / Q000523:psychology; D014481:United States