title: Assessing the burden of hospitalized and community-care heart failure in Canada.
abstract: BACKGROUND
  The surveillance of heart failure (HF) is currently conducted using either survey or hospital data, which have many limitations. Because Canada is collecting medical information in administrative health data, the present study seeks to propose methods for the national surveillance of HF using linked population-based data.
  
  
  METHODS
  Linked administrative data from 5 Canadian provinces were analyzed to estimate prevalence, incidence, and mortality rates for persons with HF between 1996/1997 and 2008/2009 using 2 case definitions: (1) 1 hospitalization with an HF diagnosis in any field (H_Any) and (2) 1 hospitalization in any field or at least 2 physician claims within a 1-year period (H_Any_2P). One hospitalization with an HF diagnosis code in the most responsible diagnosis field (H_MR) was also compared. Rates were calculated for individuals aged ≥ 40 years.
  
  
  RESULTS
  In 2008/2009, combining the 5 provinces (approximately 82% of Canada's total population), both age-standardized HF prevalence and incidence were underestimated by 39% and 33%, respectively, with H_Any when compared with H_Any_2P. Mortality was higher in patients with H_MR compared with H_Any. The degree of underestimation varied by province and by age, with older age groups presenting the largest differences. Prevalence estimates were stable over the years, especially for the H_Any_2P case definition.
  
  
  CONCLUSIONS
  The prevalence and incidence of HF using inpatient data alone likely underestimates the population rates by at least 33%. The addition of physician claims data is likely to provide a more inclusive estimate of the burden of HF in Canada.
authors.affiliation: Institut national de santé publique du Québec, Québec City, Québec, Canada; Faculté de pharmacie, Université Laval, Québec City, Québec, Canada.
authors.forename: Claudia
authors.initials: C
authors.lastname: Blais
authors.affiliation: Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada. Electronic address: sulan.dai@phac-aspc.gc.ca.
authors.forename: Sulan
authors.initials: S
authors.lastname: Dai
authors.affiliation: Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada.
authors.forename: Chris
authors.initials: C
authors.lastname: Waters
authors.affiliation: Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Robitaille
authors.affiliation: Manitoba Centre for Health Policy, Winnipeg, Manitoba, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Smith
authors.affiliation: Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada; Alberta Health, Edmonton, Alberta, Canada; School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Lawrence W
authors.initials: LW
authors.lastname: Svenson
authors.affiliation: BC Ministry of Health, Victoria, British Columbia, Canada.
authors.forename: Kim
authors.initials: K
authors.lastname: Reimer
authors.affiliation: Nova Scotia Health and Wellness, Halifax, Nova Scotia, Canada.
authors.forename: Jill
authors.initials: J
authors.lastname: Casey
authors.affiliation: Saskatchewan Ministry of Health, Regina, Saskatchewan, Canada.
authors.forename: Rolf
authors.initials: R
authors.lastname: Puchtinger
authors.affiliation: Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Helen
authors.initials: H
authors.lastname: Johansen
authors.affiliation: Canadian Institute for Health Information, Toronto, Ontario, Canada.
authors.forename: Yana
authors.initials: Y
authors.lastname: Gurevich
authors.affiliation: University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Lix
authors.affiliation: Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Hude
authors.initials: H
authors.lastname: Quan
authors.affiliation: Institute for Clinical Evaluative Sciences; Department of Family and Community Medicine, University of Toronto; University Health Network, Toronto Western Hospital Family Health Team, Toronto, Ontario, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Tu
mesh_terms: D000368:Aged; D002170:Canada / Q000453:epidemiology; D019058:Community Networks / Q000706:statistics & numerical data*; D017281:Cost of Illness; D005240:Feasibility Studies; D005260:Female; D006333:Heart Failure / Q000191:economics / Q000453:epidemiology*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015996:Survival Rate / Q000639:trends