title: [The effects of implementation of heart failure guidelines in the Pordenone province: analysis of the results following databases of the regional health guide system].
abstract: BACKGROUND
  The aim of this study was to evaluate the effects of heart failure guideline implementation in the Pordenone province area, by using the regional health system databases.
  
  
  METHODS
  We created the provincial registry of hospitalization for heart failure and we defined a set of indicators to assess the adequate use of the hospital facility, the correct use of diagnostic instruments, the appropriate use of medications, the in-hospital, 6-month and 1-year mortality rates.
  
  
  RESULTS
  Up to December 31, 2002, 2977 subjects, living in the Pordenone province area, were hospitalized for heart failure (10.4 for 1000 inhabitants). Repeated hospitalizations in the years have percentage values oscillating at around 20%. The average length of hospitalization appeared declining, ranging from 11.1 days in 2000 to 10.3 days in 2002. The in-hospital death rate varied between 16-17%. The cumulative death rate within 6 months (33.2%) and 1 year (41.0%) of hospitalization resulted rather high, also considering the patients' advanced mean age (79 years). The percentage of patients who underwent an echocardiogram as outpatients in the previous year increased from 5.7% in 2000 to 13.1% in 2002. As for therapy, an increase in the percentage of patients treated with ACE-inhibitors (from 44.6 to 50.2%), sartans (from 8.2 to 11.7%), beta-blockers (from 11.7 to 16.7%) and diuretics (from 66.4 to 68.5%) was evident from 2000 to 2001. A mild reduction in the percentage of patients treated with digitalis (from 35.0 to 33.8%) and with calcium antagonists (from 22.4 to 20.9%) was also noted.
  
  
  CONCLUSIONS
  The results of this study show that it is possible to use some indicators in evaluating the effects of guideline implementation in heart failure, by using the regional health system data. The final goal is to gradually involve all the professionals in the different phases of the natural course of heart failure patients, particularly the general practitioners.
authors.affiliation: Laboratorio di Ecocardiografia U.O. di Cardiologia, A.O.S. Maria degli Angeli, Via Montereale, 24, 33170 Pordenone. piazza.rita@libero.it
authors.forename: Rita
authors.initials: R
authors.lastname: Piazza
authors.forename: Antonella
authors.initials: A
authors.lastname: Franzo
authors.forename: Siro
authors.initials: S
authors.lastname: Carniello
authors.forename: Bruno
authors.initials: B
authors.lastname: Ponga
authors.forename: Daniela
authors.initials: D
authors.lastname: Pavan
authors.forename: Ernesto
authors.initials: E
authors.lastname: Preo
authors.forename: Camillo Giulio
authors.initials: CG
authors.lastname: De Gregorio
authors.forename: Nicola
authors.initials: N
authors.lastname: Delli Quadri
authors.forename: Anna
authors.initials: A
authors.lastname: Furlan
authors.forename: Lucio
authors.initials: L
authors.lastname: Bomben
authors.forename: Enzo
authors.initials: E
authors.lastname: Hrovatin
authors.forename: Francesco
authors.initials: F
authors.lastname: Antonini-Canterin
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: Nicolosi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D007558:Italy; D008297:Male; D017410:Practice Guidelines as Topic; D012040:Regional Health Planning; D012042:Registries