Analysis of trends in hospitalizations for heart failure

Background: Over the past 10 years, efforts have been made to control the c ost of care for patients with congestive heart failure (CHF) through reduci ng hospitalizations and shortening lengths of stay, Few data are available regarding the effectiveness of these intervention strategies on a community basis. Methods and Results: We analyzed the Oregon hospital discharge database. Mu ltivariable methods were used to assess trends while controlling for confou nding factors, such as age, sex, and comorbidity. The hospital admission ra tes for CHF were stable over time in all age groups. The age- and sex-stand ardized admission rate among people aged 65 years or older decreased slight ly from 13.9/1,000 in 1991 to 12.9/1,000 in 1995. The annual hospital readm ission rate remained constant over time, with an average rate of 15.3%. The average length of hospital stay decreased from 5.01 days in 1991 to 3.95 d ays in 1995. The in-hospital mortality rate decreased from 6.9% in 1991 to 4.7% in 1995, independent of length of stay. Conclusion: We observed stable hospital admission and readmission rates for CHF, accompanied by a decreasing trend in the length of hospital stay and in-hospital mortality. Our findings raise the possibility of improved care management for heart failure over time.