Longitudinal Study of Hospital Readmissions for Heart Failure in Catalonia, 1996-1999

Abstract

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 > 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 CIE-9 release codes combination. Analysis units patient with HF and an indicative or cohort population. Statistics: 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 Ischemic cardiopathy [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 ischemic cardiopathy being top-priority groups for care intervention and thus revealing the potential which administrative data has for clinical planning and management.