BURDEN AND OUTCOMES OF HOSPITALIZATION FOR CONGESTIVE-HEART-FAILURE

Objective: To describe the hospital burden and health outcomes associa ted with admission for congestive heart failure (CHF). Design and sett ing: Descriptive follow-up study in a tertiary-level metropolitan teac hing hospital. Patients: Acute adult inpatients with a clinical diagno sis of CHF for more than 24 hours admitted to Westmead Hospital, Sydne y, during the four months from September 1993 to January 1994. At base line, 122 patients were assessed; 88 patients were assessed at four-mo nth follow-up. Interventions: Usual clinical care. Main outcome measur es: Length of stay; hospital bed-days; readmissions; mortality; health related quality of life (SF-36); patient knowledge. Results: The aver age age of subjects was 73.4 years. Many were using informal domicilia ry care before admission. Mean length of stay for the baseline admissi on was 13.8 days, accounting for 7.6% of hospital separations and 1683 hospital bed-days, or 4.2% of bed-days for all inpatients aged 65 yea rs and over. Fifteen patients were readmitted for CHF during the follo wing four months, with a total of 26 CHF-related admissions. Twenty-on e patients (17.2%) died during the course of the study. Quality of lif e at baseline was poor compared,with population normative data, with a slight improvement among survivors at four-month follow-up. Patient k nowledge of CHF was poor in a subsample survey (n = 24). Conclusions: CHF represents a significant burden to patients (through morbidity and mortality), their carers (through provision of daily care), and hospi tals (through multiple admissions for acute decompensation). It is dif ficult to monitor the hospital burden of CHF using routine data source s.