[Longitudinal study of hospital readmission for congestive heart failure in Cataluña. 1996-1999].
BACKGROUND
This study is aimed at describing the readmission phenomenon for heart failure patients and identifying some of their related clinical factors by means of a follow-up study with administrative data.


METHODS
Longitudinal study of readmissions due to heart failure (HF) among a population > or = age 65 in Catalonia throughout the 1996-1999 period. Information source: Minimum Basic Set of Data of Hospital Discharges from the Catalan Health Service. Definition of HF, etiological or precipitating cause, and comorbility by means of a ICD-9 discharge release codes combination. Analysis units "patient with HF" and an index population or cohort".


METHODS
Survival analysis (Kaplan-Meier and Log-rank test) and regression models (Cox).


RESULTS
The follow-up populations, comprised of 16,919 patients, generated 44,283 admissions (61.8%). The length of time free of readmissions (Mean "ME" in months) and the comparison of the survival curves is statistically significant with lower values in the following categories: 'age 65-74' (ME = 21.6 months); 'male' (23.3); 'healthcare region 6' (16.3); 'reference hospital' (22.9) and 'pure COPD related to the HF (17.7),. The highest risk of readmission, adjusted by the other variables under study, has been found for 'pure COPD' [RR = 1.03, (95% CI: 1.02-1.04), p < 0.001], and ischaemic heart disease [RR = 1.03, (95% CI: 1.01-1.05), p = 0.003].


CONCLUSIONS
This study reveals the clinical complexity and patterns of utilization of hospitals on the part of patients with heart failure, identifying that those having COPD or ischaemic heart disease being top-priority groups for care intervention and thus revealing the potential which administrative data has for clinical planning and management.
Caminal
Josefina
J
Universitat Autònoma de Barcelona, Campus de Bellaterra, Edifici M (08193) Cerdanyola del Vallés. josefina.caminal@uab.es
Hermosilla
Eduardo
E
Sánchez
Emilia
E
Urrea
Mireya
M
Puig
Pere
P
Tomàs
Lluís
L
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data*; D013030:Spain / Q000453:epidemiology