Age and quality of in-hospital care of patients with heart failure.
BACKGROUND
Elderly patients may be at risk of suboptimal care. Thus, the relationship between age and quality of care for patients hospitalized for heart failure was examined.


METHODS
A cross-sectional study based on retrospective chart review was performed among a random sample of patients hospitalized between 1996 and 1998 in the general internal medicine wards, with a principal diagnosis of congestive heart failure, and discharged alive. Explicit criteria of quality of care, grouped into three scores, were used: admission work-up (admission score); evaluation and treatment during the stay (evaluation and treatment score); and readiness for discharge (discharge score). The associations between age and quality of care scores were analysed using linear regression models.


RESULTS
Charts of 371 patients were reviewed. Mean age was 75.7 (+/-11.1) years and 52% were men. There was no relationship between age and admission or readiness for discharge scores. The evaluation and treatment score decreased with age: compared with patients less than 70 years old, the score was lower by -2.6% (95% CI: -7.1 to 1.9) for patients aged 70 to 79, by -8.7% (95% CI: -13.0 to -4.3) for patients aged 80 to 89, and by -19.0% (95% CI: -26.6 to -11.5) for patients aged 90 and over. After adjustment for possible confounders, this relationship was not significantly modified.


CONCLUSIONS
In patients hospitalized for congestive heart failure, older age was not associated with lower quality of care scores except for evaluation and treatment. Whether this is detrimental to elderly patients remains to be evaluated.
Kossovsky
Michel P
MP
Department of Internal Medicine, Geneva University Hospitals, Switzerland. michel.picard-kossovsky@hcuge.ch
Sarasin
François P
FP
Louis-Simonet
Martine
M
Chopard
Pierre
P
Sigaud
Philippe
P
Perneger
Thomas V
TV
Gaspoz
Jean-Michel
JM
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006299:Health Services for the Aged / Q000592:standards*; D006333:Heart Failure / Q000628:therapy*; D006779:Hospitals, Public / Q000592:standards* / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007388:Internal Medicine / Q000592:standards*; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011787:Quality of Health Care; D013557:Switzerland