Geographical variation in hospitalization and mortality for congestive heart failure in Spain, 1980-1993

Background and objectives. Geographical differences in hospitalizations and mortality for heart failure serve to estimate the potential for reducing t he associated hospital and demographic burden on the population. Accordingl y, the objective of this paper is to analyze the geographic variation in he art failure hospitalizations and mortality in Spain during the period of 19 80-1993, and to examine their potential determinants. Methods. Data on the primary diagnosis of heart failure were taken from the National Hospital Morbidity Survey and National Vital Statistics. Informat ion on determinants of heart failure were obtained from large-scale nationa lly representative surveys conducted by the National Statistics Office. Results. The period of 1980-1993 witnessed a decrease in geographical diffe rences in heart failure hospitalizations and mortality. Theoretically, howe ver, heart failure hospitalizations and mortality among persons aged greate r than or equal to 45 years could still be further reduced by 60% and 30% r espectively. In the period of 1989-1993 heart failure hospitalizations were correlated (p < 0.05) with ischaemic heart disease hospitalizations and th e number of beds/1,000 inhabitants. Heart failure mortality showed a statis tically significant correlation (p < 0.05) with ischaemic heart disease mor tality, illiteracy and unemployed status. Conclusions. There is a great potential for a reduction in the hospital and demographic burden of heart failure in Spain. Control of ischaemic heart d isease and a reduction in the geographical differences in socio-economic st atus would probably contribute to lessening the healthcare burden of heart failure in Spain.