In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 139, No. Suppl_1 ( 2019-03-05)
Abstract:
Introduction: Periodic surveillance of geographical variations in cardiovascular health is important to achieve the goal of reducing regional disparities in healthcare delivery. We aimed to study differences in epidemiology and outcomes of heart failure admissions by geographic regions in the United States. Hypothesis: We assessed the hypothesis that there exist differences in the outcomes of heart failure admissions based on geographic region. Methods: The National Inpatient Sample database for the year 2016 was queried. Adult patients admitted with a principal diagnosis of heart failure were identified using validated ICD-10 codes. Comparisons were made between four regions - Northeast, Midwest, South and West. Baseline characteristics of heart failure admissions were identified. The main outcomes of interest were inpatient mortality, length of stay and hospital charges. Statistical analysis was performed using STATA. Results: A total of 807,764 hospitalizations with a principal diagnosis of heart failure were identified. Of these, 153,233 (18.97%) were in the Northeast; 184,090 (22.79%) in the Midwest; 331,506 (41.04%) in the South; and 138,935 (17.20%) in the West. The baseline characteristics of these admissions and outcomes of interest are depicted in the table. There was a small difference in the mortality rates (highest in West at 3%, and lowest in South at 2.66%, p=0.03) and length of stay (longest in the Northeast, and shortest in the West, p 〈 0.001) between regions. A significant difference was observed in the total hospital charges per hospitalization (nearly $65,000 in the West, and only $37,000 in the Midwest, p 〈 0.001). The differences in all outcomes persisted after adjusting for variables like age, gender, race and co-morbid conditions. Conclusions: Our study demonstrates the existence of regional differences in the costs and outcomes of healthcare delivery to heart failure patients. Further research is needed to explore the reasons for these differences.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.139.suppl_1.P135
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2019
detail.hit.zdb_id:
1466401-X
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