title: Preventable hospitalizations for congestive heart failure: establishing a baseline to monitor trends and disparities.
abstract: BACKGROUND
  Preventable hospitalization for congestive heart failure (CHF) is believed to capture the failure of the outpatient health care system to properly manage and treat CHF. In anticipation of changes in the national health care system, we report baseline rates of these hospitalizations and describe trends by race over 15 years.
  
  
  METHODS
  We used National Hospital Discharge Survey data from 1995 through 2009, which represent approximately 1% of hospitalizations in the United States each year. We calculated age-, sex-, and race-stratified rates and age- and sex-standardized rates for preventable CHF hospitalizations on the basis of the Agency for Healthcare Research and Quality's specifications, which use civilian population estimates from the US Census Bureau as the denominator for rates.
  
  
  RESULTS
  Approximately three-fourths of the hospitalizations occurred among people aged 65 years or older. In each subgroup and period, rates were significantly higher (P < .05) for blacks than whites. Only black men aged 18 to 44 showed a linear increase (P = .004) in crude rates across time. Subpopulations aged 65 or older, except black men, showed a linear decrease (P < .05) in crude rates over time. Age- and sex-standardized rates showed a significant linear decrease in rates for whites (P = .01) and a borderline decrease for blacks (P = .06)
  
  
  CONCLUSIONS
  Before implementation of the Patient Protection and Affordable Care Act, we found that blacks were disproportionately affected by preventable CHF hospitalizations compared with whites. Our results confirm recent findings that preventable CHF hospitalization rates are declining in whites more than blacks. Alarmingly, rates for younger black men are on the rise.
authors.affiliation: Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention, 4770 Buford Hwy NE, Mailstop F-72, Atlanta, GA 30341, USA. jxw6@cdc.gov
authors.forename: Julie C
authors.initials: JC
authors.lastname: Will
authors.forename: Amy L
authors.initials: AL
authors.lastname: Valderrama
authors.forename: Paula W
authors.initials: PW
authors.lastname: Yoon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D005260:Female; D054625:Healthcare Disparities / Q000639:trends*; D006333:Heart Failure / Q000517:prevention & control*; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D012737:Sex Factors; D013997:Time Factors; D055815:Young Adult