Cm. Ashton et al., Rates of health services utilization and survival in patients with heart failure in the Department of Veterans Affairs Medical Care System, AM J MED QU, 14(1), 1999, pp. 55-63
The objective of this study was to describe patterns of hospital and clinic
use and survival for a large nationwide cohort of patients with heart fail
ure. A retrospective co hort study of patients treated in the Veterans Affa
irs medical care system was conducted using linked administrative databases
as data sources. In 1996, the average heart failure cohort member had 1-2
hospitalizations, 14 inpatient days, 6-7 visits with the primary physician,
15 other visits for consultations or tests, and 1-2 urgent care visits per
12 months. The overall risk-adjusted 5-year survival rate was 36%. Hospita
l use rates in the cohort fell dramatically between 1992 and 1996. One-year
survival rates increased slightly over the period. Patients with heart fai
lure are heavy users of services and have a very poor prognosis. Utilizatio
n and outcome data indicate the need for major efforts to assure quality of
care and to devise innovative ways of delivering comprehensive services.