title: Self-rated health predicts healthcare utilization in heart failure.
abstract: BACKGROUND
  Heart failure (HF) patients experience impaired functional status, diminished quality of life, high utilization of healthcare resources, and poor survival. Yet, the identification of patient-centered factors that influence prognosis is lacking.
  
  
  RESULTS
  We determined the association of 2 measures of self-rated health with healthcare utilization and skilled nursing facility (SNF) admission in a community cohort of 417 HF patients prospectively enrolled between October 2007 and December 2010 from Olmsted County, MN. Patients completed a 12-item Short Form Health Survey (SF-12). Low self-reported physical functioning was defined as a score ≤ 25 on the SF-12 physical component. The first question of the SF-12 was used as a measure of self-rated general health. After 2 years, 1033 hospitalizations, 1407 emergency department (ED) visits, and 19,780 outpatient office visits were observed; 87 patients were admitted to a SNF. After adjustment for confounding factors, an increased risk of hospitalizations (1.52 [1.17 to 1.99]) and ED visits (1.48 [1.04 to 2.11]) was observed for those with low versus moderate-high self-reported physical functioning. Patients with poor and fair self-rated general health also experienced an increased risk of hospitalizations (poor: 1.73 [1.29 to 2.32]; fair: 1.46 [1.14 to 1.87]) and ED visits (poor: 1.73 [1.16 to 2.56]; fair: 1.48 [1.13 to 1.93]) compared with good-excellent self-rated general health. No association between self-reported physical functioning or self-rated general health with outpatient visits and SNF admission was observed.
  
  
  CONCLUSIONS
  In community HF patients, self-reported measures of physical functioning predict hospitalizations and ED visits, indicating that these patient-reported measures may be useful in risk stratification and management in HF.
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN (A.M.C., S.M.M., S.M.D., C.B., S.A.W., R.).
authors.forename: Alanna M
authors.initials: AM
authors.lastname: Chamberlain
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN (A.M.C., S.M.M., S.M.D., C.B., S.A.W., R.).
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Manemann
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN (A.M.C., S.M.M., S.M.D., C.B., S.A.W., R.) Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (S.M.D., M.M.R., R.).
authors.forename: Shannon M
authors.initials: SM
authors.lastname: Dunlay
authors.affiliation: Division of Cardiology, Department of Medicine, University of Missouri at Kansas City, Kansas City, MO (J.A.S.).
authors.forename: John A
authors.initials: JA
authors.lastname: Spertus
authors.affiliation: College of Nursing, University of Kentucky, Lexington, KY (D.K.M.).
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN (A.M.C., S.M.M., S.M.D., C.B., S.A.W., R.).
authors.forename: Cecilia
authors.initials: C
authors.lastname: Berardi
authors.affiliation: Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN (R.L.K.).
authors.forename: Robert L
authors.initials: RL
authors.lastname: Kane
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN (A.M.C., S.M.M., S.M.D., C.B., S.A.W., R.).
authors.forename: Susan A
authors.initials: SA
authors.lastname: Weston
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (S.M.D., M.M.R., R.).
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Redfield
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN (A.M.C., S.M.M., S.M.D., C.B., S.A.W., R.) Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (S.M.D., M.M.R., R.).
authors.forename: Véronique L
authors.initials: VL
authors.lastname: Roger
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D009819:Office Visits / Q000706:statistics & numerical data; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data
keywords: healthcare utilization; heart failure; hospitalizations; physical functioning; self‐rated health